Edinburgh Napier University

  Introduction: Exercise referral can be offered by health professionals, to inactive individuals with an existing health condition/risk (for example NICE PH54). Policy and evidence fail to consider inequalities in terms of sociodemographic factors at referral point, or impact on programme effectiveness. We report part of a wider evaluation considering obese/ overweight referrals specifically.
Method: 3,624 referrals (40% of wider evaluation referrals) for overweight/obesity (BMI>24.9 kg/m2) were made from 2009-2014 to a 24-week leisure centre-based exercise scheme in north-east England. Weight-related measurements were taken at baseline, 3 and 6 months; physical activity (PA, Godin Leisure-Time Exercise Questionnaire) at baseline, 6 and 12 months. A random effect linear model accounting for repeated measures, examined associations of outcome variables and sociodemographic predictors.
Results: Weight, BMI and waist circumference were reduced at 3 (1.8 kg, −0.39 kg/m2, −2.48 cm) and 6 months (−2.2 kg, −0.31 kg/m2, −3.11 cm). Weight-related variables tended to be higher for referrals living in the 20% most deprived areas, those in receipt of benefits and those referred by GP versus practice nurse. Across all time-points, weight and PA were negatively associated with age and lower among females (P < 0.001). PA increased by 6 months, remaining so at 12 months (P < 0.01), and only varied by IMD quintile at 12 months when those in the most deprived 20% reported greatest PA.
Conclusion: Exercise referral was a popular pathway for obese/overweight, resulting in modest weight reduction and increased PA. The scheme did not widen inequalities and demonstrated greatest PA benefit for those most disadvantaged.