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The Northumberland Exercise Referral Scheme as a Universal Community Weight Management Programme: A Mixed Methods Exploration of Outcomes, Expectations and Experiences across a Social Gradient

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  • Caroline J. Dodd-Reynolds

    (Department of Sport and Exercise Sciences, Durham University, Durham DH1 3HN, UK
    Wolfson Research Institute for Health and Wellbeing Physical Activity Special Interest Group, Durham University, Durham DH1 3HN, UK
    Durham Research Methods Centre, Durham University, Durham DH1 3HN, UK)

  • Dimitris Vallis

    (Durham Research Methods Centre, Durham University, Durham DH1 3HN, UK)

  • Adetayo Kasim

    (Wolfson Research Institute for Health and Wellbeing Physical Activity Special Interest Group, Durham University, Durham DH1 3HN, UK
    Durham Research Methods Centre, Durham University, Durham DH1 3HN, UK
    Department of Anthropology, Durham University, Durham DH1 3HN, UK)

  • Nasima Akhter

    (Wolfson Research Institute for Health and Wellbeing Physical Activity Special Interest Group, Durham University, Durham DH1 3HN, UK
    Department of Anthropology, Durham University, Durham DH1 3HN, UK)

  • Coral L. Hanson

    (School of Health and Social Care, Edinburgh Napier University, Edinburgh EH11 4BN, UK)

Abstract

Exercise referral schemes (ERS) are internationally recognised, yet little attention has been paid to discrete referral groups or the influence of wider social determinants of health. The primary quantitative element of this mixed methods study used a mixed effects linear model to examine associations of sociodemographic predictors, obesity class and profession of referrer on weight and physical activity (PA) variables for weight-related referrals ( n = 3624) to an established 24-week ERS. Chained equations modelling imputed missing data. The embedded qualitative element ( n = 7) used individual semi-structured interviews to explore participant weight-related expectations and experiences. Age, gender and profession of referrer influenced weight loss. PA increased and was influenced by age and gender. The weight gap between the most and least obese narrowed over time but the PA gap between most and least widened. Age, employment and obesity class were most predictive of missing data but would unlikely alter overall conclusions. Qualitative themes were weight-loss support, personal circumstances and strategies, and weight expectations versus wellbeing rewards. This ERS worked, did not widen existing obesity inequalities, but demonstrated evidence of PA inequalities for those living with deprivation. To improve equity of experience, we recommend further stakeholder dialogue around referral experience and ongoing support needs.

Suggested Citation

  • Caroline J. Dodd-Reynolds & Dimitris Vallis & Adetayo Kasim & Nasima Akhter & Coral L. Hanson, 2020. "The Northumberland Exercise Referral Scheme as a Universal Community Weight Management Programme: A Mixed Methods Exploration of Outcomes, Expectations and Experiences across a Social Gradient," IJERPH, MDPI, vol. 17(15), pages 1-21, July.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:15:p:5297-:d:388400
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    References listed on IDEAS

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    1. White, Ian R. & Daniel, Rhian & Royston, Patrick, 2010. "Avoiding bias due to perfect prediction in multiple imputation of incomplete categorical variables," Computational Statistics & Data Analysis, Elsevier, vol. 54(10), pages 2267-2275, October.
    2. Tim Althoff & Rok Sosič & Jennifer L. Hicks & Abby C. King & Scott L. Delp & Jure Leskovec, 2017. "Large-scale physical activity data reveal worldwide activity inequality," Nature, Nature, vol. 547(7663), pages 336-339, July.
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    Cited by:

    1. Emily J. Oliver & Caroline Dodd-Reynolds & Adetayo Kasim & Dimitrios Vallis, 2021. "Inequalities and Inclusion in Exercise Referral Schemes: A Mixed-Method Multi-Scheme Analysis," IJERPH, MDPI, vol. 18(6), pages 1-19, March.
    2. Jordan Bell & Lis Neubeck & Kai Jin & Paul Kelly & Coral L. Hanson, 2021. "Understanding Leisure Centre-Based Physical Activity after Physical Activity Referral: Evidence from Scheme Participants and Completers in Northumberland UK," IJERPH, MDPI, vol. 18(6), pages 1-14, March.

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