Being physically active is a key factor in maintaining good cardiovascular health however many people find being physically active hard to incorporate into their lifestyles. “Exercise on prescription” interventions that involve a health professional’s written advice to a patient to be more physically active have been used with variable success. A meta-analysis of the efficacy of gym-based exercise referrals for inactive people with medical conditions (Williams, Hendry, France, Lewis, & Wilkinson, 2007) suggested that while these were effective the absolute health risk reduction was small due to patients failing to maintain activity levels over time. The authors show that, across the studies, 17 sedentary people would have to be referred for one person to become moderately active. They cite a range of lifestyle and resource factors that limit the efficacy of these interventions.
Given the lack of time and potential access limitations, it is important to find ways, other than expensive face-to-face programs, to provide individuals with information, skills, and knowledge to facilitate behaviour change. This study looks at the efficacy of two interventions intended to overcome some of the barriers identified above, both with a focus on making activity fun by linking it with entry-level sporting activity.
To test the independent and synergistic efficacy of a 12-week sports oriented exercise referral intervention and a self-help web-based intervention intended to promote sustained and increased levels of physical activity over a period of 12 months. Do these interventions separately and in combination improve these indicators and do they improve them above that expected by existing gym-based GP referral alone?
We are also asking whether these interventions improve other clinical indicators of cardiovascular health (e.g. BMI, waist and hip measures, blood pressure and other measures that contribute to the QRisk2 risk indicator[1]) above that expected by existing gym-based GP referral? Do these interventions increase participation in sporting activity over a period of 12 months?
[1] http://www.qresearch.org/SitePages/qriskInformationforClinicians.aspx
The study involves a 4-arm randomised controlled trial (RCT) to test two types of GP referral intervention that are intended to increase physical and sporting activity among currently inactive 18-74 year old people with hypertension, suspected hypertension, pre-hypertension or high-normal blood pressure. This study will assess the efficacy of a 12-week sports-oriented exercise programme, the efficacy of a web-delivered interactive tool to promote and support sports participation and healthy behaviour change and the effect of these interventions in combination. The control arm will be a standard care GP referral for gym-based exercise. The interventions focus on promoting sporting activity with the assumption that this will prove more engaging and motivating for participants than existing gym-based exercise referrals.
The primary outcome measures will be time spent in physical activity assessed in metabolic equivalent minutes per week (MET-minutes per week) using the International Physical Activity Questionnaire (IPAQ short form). Secondary outcome measures will include increased involvement in sporting activity and biomedical health outcomes including change in body mass index (BMI), and waist and hip measurement and reductions in blood pressure.
