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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

Dodd-Reynolds, Caroline J.; Vallis, Dimitris; Kasim, Adetayo; Akhter, Nasima; Hanson, Coral


Caroline J. Dodd-Reynolds

Dimitris Vallis

Adetayo Kasim

Nasima Akhter


Exercise referral schemes (ERS) are internationally recognised, yet little attention has been paid to discrete referral groups, nor 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=3,624) 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 deprived 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.

Journal Article Type Article
Acceptance Date Jul 21, 2020
Online Publication Date Jul 23, 2020
Publication Date Jul 23, 2020
Deposit Date Jul 21, 2020
Publicly Available Date Aug 28, 2020
Journal International Journal of Environmental Research and Public Health
Publisher MDPI
Peer Reviewed Peer Reviewed
Volume 17
Issue 15
Article Number 855929
Keywords Exercise referral; Obesity; Physical activity; Inequalities; Sociodemographic
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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 (published version) (2 Mb)

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Copyright Statement
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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