Levels and predictors of exercise referral scheme uptake and adherence: a systematic review

Pavey, Toby, Taylor, Adrian, Hillsdon, Melvyn, Fox, Kenneth, Campbell, John, Foster, Charlie, Moxham, Tiffany, Mutrie, Nanette, Searle, John and Taylor, Rod (2012) Levels and predictors of exercise referral scheme uptake and adherence: a systematic review. Journal of Epidemiology and Community Health, 66 8: 737-744.


Author Pavey, Toby
Taylor, Adrian
Hillsdon, Melvyn
Fox, Kenneth
Campbell, John
Foster, Charlie
Moxham, Tiffany
Mutrie, Nanette
Searle, John
Taylor, Rod
Title Levels and predictors of exercise referral scheme uptake and adherence: a systematic review
Journal name Journal of Epidemiology and Community Health   Check publisher's open access policy
ISSN 0143-005X
1470-2738
Publication date 2012-08
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1136/jech-2011-200354
Volume 66
Issue 8
Start page 737
End page 744
Total pages 8
Place of publication London, United Kingdom
Publisher BMJ Group
Collection year 2013
Language eng
Formatted abstract Background The effectiveness of exercise referral schemes (ERS) is influenced by uptake and adherence to the scheme. The identification of factors influencing low uptake and adherence could lead to the refinement of schemes to optimise investment.
Objectives To quantify the levels of ERS uptake and adherence and to identify factors predictive of uptake and adherence.
Methods A systematic review and meta-analysis was undertaken. MEDLINE, EMBASE, PsycINFO, Cochrane Library, ISI WOS, SPORTDiscus and ongoing trial registries were searched (to October 2009) and included study references were checked. Included studies were required to report at least one of the following: (1) a numerical measure of ERS uptake or adherence and (2) an estimate of the statistical association between participant demographic or psychosocial factors (eg, level of motivation, self-efficacy) or programme factors and uptake or adherence to ERS.
Results Twenty studies met the inclusion criteria, six randomised controlled trials (RCTs) and 14 observational studies. The pooled level of uptake in ERS was 66% (95% CI 57% to 75%) across the observational studies and 81% (95% CI 68% to 94%) across the RCTs. The pooled level of ERS adherence was 49% (95% CI 40% to 59%) across the observational studies and 43% (95% CI 32% to 54%) across the RCTs. Few studies considered anything other than gender and age. Women were more likely to begin an ERS but were less likely to adhere to it than men. Older people were more likely to begin and adhere to an ERS.
Limitations Substantial heterogeneity was evident across the ERS studies. Without standardised definitions, the heterogeneity may have been reflective of differences in methods of defining uptake and adherence across studies.
Conclusions To enhance our understanding of the variation in uptake and adherence across ERS and how these variations might affect physical activity outcomes, future trials need to use quantitative and qualitative methods.
Keyword Randomized controlled trial
Physical activity promotion
Prescription scheme
Self-determination
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2013 Collection
School of Human Movement Studies Publications
 
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