TY - JOUR
T1 - A new model of exercise referral scheme in primary care
T2 - Is the effect on adherence to physical activity sustainable in the long term? A 15-month randomised controlled trial
AU - PPAF Group
AU - Martín-Borràs, Carme
AU - Giné-Garriga, Maria
AU - Puig-Ribera, Anna
AU - Martín, Carlos
AU - Solà, Mercè
AU - Cuesta-Vargas, Antonio I.
AU - Losada, José Antonio
AU - Albarrilla, Elena
AU - Muñoz, Miquel
AU - Castillo, Eva
AU - Guiu, Agustí
AU - Cascos, Ana
AU - Fernández, Esperanza
AU - Martínez, Cristina
AU - Duran, Eulàlia
AU - Rivera, Maribel
AU - Martin, Cristina
AU - Castro, Mònica
AU - Roig, Immaculada
AU - Pérez, Cristina
AU - Sánchez, M. Roser
AU - Pastor, Luz
AU - Briones, Elena
AU - Del Val, Jose Luis
AU - Rodríguez-Alcazar, Miguel
AU - Jiménez-Grande, Miguel
AU - Sampedro-Fernández, Josefa
AU - Martín-Ruiz, María Del Carmen
N1 - Funding Information:
Funding This work was supported by a research grant from the Catalan Society of General Practice (CAMFIC) (grant no: 2009/010).
Publisher Copyright:
© 2018 Article author(s). All rights reserved.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Introduction: Studies had not yet overcome the most relevant barriers to physical activity (PA) adherence. An exercise referral scheme (ERS) with mechanisms to promote social support might enhance adherence to PA in the long term. Setting: A randomised controlled trial in 10 primary care centres in Spain. Objective: To assess the effectiveness of a primary care-based ERS linked to municipal resources and enhancing social support and social participation in establishing adherence to PA among adults over a 15-month period. Participants: 422 insufficiently active participants suffering from at least one chronic condition were included. 220 patients (69.5 (8.4) years; 136 women) were randomly allocated to the intervention group (IG) and 202 (68.2 (8.9) years; 121 women) to the control group (CG). Interventions: The IG went through a 12-week standardised ERS linked to community resources and with inclusion of mechanisms to enhance social support. The CG received usual care from their primary care practice. Outcomes: The main outcome measure was self-report PA with the International Physical Activity Questionnaire and secondary outcomes included stages of change and social support to PA practice. Data collection: Participant-level data were collected via questionnaires at baseline, and at months 3, 9 and 15. Blinding: The study statistician and research assessors were blinded to group allocation. Results: Compared with usual care, follow-up data at month 15 for the ERS group showed a significant increase of self-reported PA (IG: 1373±1845 metabolic equivalents (MET) min/week, n=195; CG: 919±1454 MET min/week, n=144; P=0.009). Higher adherence (in terms of a more active stage of change) was associated with higher PA level at baseline and with social support. Conclusions: Prescription from ordinary primary care centres staff yielded adherence to PA practice in the long term. An innovative ERS linked to community resources and enhancing social support had shown to be sustainable in the long term.
AB - Introduction: Studies had not yet overcome the most relevant barriers to physical activity (PA) adherence. An exercise referral scheme (ERS) with mechanisms to promote social support might enhance adherence to PA in the long term. Setting: A randomised controlled trial in 10 primary care centres in Spain. Objective: To assess the effectiveness of a primary care-based ERS linked to municipal resources and enhancing social support and social participation in establishing adherence to PA among adults over a 15-month period. Participants: 422 insufficiently active participants suffering from at least one chronic condition were included. 220 patients (69.5 (8.4) years; 136 women) were randomly allocated to the intervention group (IG) and 202 (68.2 (8.9) years; 121 women) to the control group (CG). Interventions: The IG went through a 12-week standardised ERS linked to community resources and with inclusion of mechanisms to enhance social support. The CG received usual care from their primary care practice. Outcomes: The main outcome measure was self-report PA with the International Physical Activity Questionnaire and secondary outcomes included stages of change and social support to PA practice. Data collection: Participant-level data were collected via questionnaires at baseline, and at months 3, 9 and 15. Blinding: The study statistician and research assessors were blinded to group allocation. Results: Compared with usual care, follow-up data at month 15 for the ERS group showed a significant increase of self-reported PA (IG: 1373±1845 metabolic equivalents (MET) min/week, n=195; CG: 919±1454 MET min/week, n=144; P=0.009). Higher adherence (in terms of a more active stage of change) was associated with higher PA level at baseline and with social support. Conclusions: Prescription from ordinary primary care centres staff yielded adherence to PA practice in the long term. An innovative ERS linked to community resources and enhancing social support had shown to be sustainable in the long term.
KW - adherence
KW - chronic condition
KW - insufficiently active population
KW - physical activity referral schemes
KW - primary health care
UR - http://www.scopus.com/inward/record.url?scp=85043296626&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2017-017211
DO - 10.1136/bmjopen-2017-017211
M3 - Article
C2 - 29502081
AN - SCOPUS:85043296626
VL - 8
JO - BMJ open
JF - BMJ open
IS - 3
M1 - e017211
ER -