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Gender differences in uptake, adherence and experiences: a longitudinal, mixed methods study of a physical activity referral scheme in Scotland, UK

Hanson, Coral L.; Neubeck, Lis; Kyle, Richard G.; Brown, Norrie; Gallagher, Robyn; Clark, Robyn A.; McHale, Sheona; Dawkes, Susan


Richard G. Kyle

Norrie Brown

Robyn Gallagher

Robyn A. Clark

Susan Dawkes


Physical activity referral schemes (PARS) are implemented internationally to increase physical activity (PA) but evidence of effectiveness for population subgroups is equivocal. We examined gender differences for a Scottish PARS. This mixed-method, concurrent longitudinal study had equal status quantitative and qualitative components. We conducted 348 telephone interviews across three time points (pre-scheme, 12 and 52 weeks). These included validated self-reported PA and exercise self-efficacy measures, and open-ended questions about experiences. We recruited 136 participants, 120 completed 12-week and 92 completed 52-week interviews. PARS uptake was 83.8% (114/136) and 12-week adherence for those who started was 43.0% (49/114). Living in less deprived areas was associated with better uptake (p=0.021) and 12-week adherence (p=0.020), and with male uptake (p=0.024) in gender-stratified analysis. Female adherers significantly increased self-reported PA at 12 weeks (p=0.005) but not 52 weeks. Males significantly increased exercise self-efficacy between baseline and 52 weeks (p=0.009). Three qualitative themes and eight subthemes developed; gender perspectives, personal factors (health, social circumstances, transport and attendance benefits) and scheme factors (communication, social/staff support, individualisation and age appropriateness). Both genders valued the PARS. To increase uptake, adherence and PA, PARS should ensure timely, personalized communication, individualised, affordable PA and include mechanisms to re-engage those who disengage temporarily.

Journal Article Type Article
Acceptance Date Feb 4, 2021
Online Publication Date Feb 10, 2021
Publication Date 2021-02
Deposit Date Feb 10, 2021
Publicly Available Date Feb 11, 2021
Journal International Journal of Environmental Research and Public Health
Electronic ISSN 1660-4601
Publisher MDPI
Peer Reviewed Peer Reviewed
Volume 18
Issue 4
Article Number 1700
Keywords Physical activity; public health; adherence; uptake; exercise referral; gender; mixed methods
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Gender Differences In Uptake, Adherence And Experiences: A Longitudinal, Mixed Methods Study Of A Physical Activity Referral Scheme In Scotland, UK (published version) (678 Kb)

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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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