The proposed project will evaluate the post-trial implementation and long-term clinical effectiveness of the Welsh National Exercise Referral Scheme [NERS] across all 22 Local Authorities [LAs] in Wales.
Physical inactivity is a major cause of preventable illness and significant cost to the NHS. In Wales, 71% of adults are not sufficiently active. Increasing physical activity at the population level, and among at risk groups, is a public health priority. While an earlier evaluation of NERS revealing promising impacts upon self-reported physical activity and mental health outcome at 12-month follow-up, the ongoing fidelity of implementation and long-term effectiveness on health outcomes is unknown; understanding the longer-term maintenance of implementation and effects of evidence-based interventions is a major empirical gap in the public health literature. What evidence there is to date suggests that evidence-based interventions are often not widely adopted or are adopted with insufficient quality and fidelity following trials of their effectiveness. Furthermore, use of self-reported outcomes may have subjected data to inaccuracies and the follow-up of participants in the longer-term may be necessary to demonstrate significant improvements in a variety of health outcomes.
This proposal aligns with Welsh government strategy which identifies physical activity as a priority area. It addresses NICE research recommendations, as well as service delivery recommendations of Public Health Wales’ Health Improvement Review, focused on furthering the impact of NERS through innovation and research.