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A systematic review and narrative synthesis of physical activity referral schemes’ components

Mino, Eriselda; Hanson, Coral; Naber, Inga; Weissenfels, Anja; McHale, Sheona; Saftig, Jane; Klamroth, Sarah; Gelius, Peter; Abu-Omar, Karim; Whiting, Stephen; Wickramasinghe, Kremlin; Galea, Gauden; Pfeifer, Klaus; Geidl, Wolfgang

Authors

Eriselda Mino

Inga Naber

Anja Weissenfels

Jane Saftig

Sarah Klamroth

Peter Gelius

Karim Abu-Omar

Stephen Whiting

Kremlin Wickramasinghe

Gauden Galea

Klaus Pfeifer

Wolfgang Geidl



Abstract

Background: Physical activity referral schemes (PARS) are complex multicomponent interventions that represent a promising healthcare-based concept for physical activity (PA) promotion. This systematic review and narrative synthesis aimed to identify the constitutive components of PARS and provide an overview of their effectiveness. Methods: Following a published protocol, we conducted a systematic search of PubMed, Scopus, Web of Science, CINAHL, ScienceDirect, SpringerLink, HTA, Wiley Online Library, SAGE Journals, Taylor & Francis, Google Scholar, OpenGrey, and CORE from 1990 to January 2023. We included experimental, quasi-experimental, and observational studies that targeted adults participating in PARS and reported PA outcomes, scheme uptake, or adherence rates. We performed an intervention components analysis using the PARS taxonomy to identify scheme components and extracted data related to uptake, adherence, and PA behavior change. We combined these to provide a narrative summary of PARS effectiveness. Results: We included 57 studies reporting on 36 PARS models from twelve countries. We identified 19 PARS components: a patient-centered approach, individualized content, behavior change theory and techniques, screening, brief advice, written materials, a written prescription, referral, baseline and exit consultation, counselling support session(s), PA sessions, education session(s), action for non-attendance, structured follow-up, a PA network, feedback for the referrer, and exit strategies/routes. The PARS models contained a mean of 7 ± 2.9 components (range = 2–13). Forty-five studies reported PA outcome data, 28 reported uptake, and 34 reported adherence rates. Of these, approximately two-thirds of studies reported a positive effect on participant PA levels, with a wide range of uptake (5.7–100.0%) and adherence rates (8.5–95.0%). Conclusions: Physical activity referral scheme components are an important source of complexity. Despite the heterogeneous nature of scheme designs, our synthesis was able to identify 19 components. Further research is required to determine the influence of these components on PARS uptake, adherence, and PA behavior change. To facilitate this, researchers and scheme providers must report PARS designs in more detail. Process evaluations are also needed to examine implementation and increase our understanding of what components lead to which outcomes. This will facilitate future comparisons between PARS and enable the development of models to maximize impact.

Journal Article Type Article
Acceptance Date Sep 20, 2023
Online Publication Date Nov 27, 2023
Publication Date 2023
Deposit Date Sep 22, 2023
Publicly Available Date Dec 1, 2023
Electronic ISSN 1479-5868
Publisher BMC
Peer Reviewed Peer Reviewed
Volume 20
Article Number 140
DOI https://doi.org/10.1186/s12966-023-01518-x
Keywords physical activity, physical activity referral scheme, healthcare, physical activity prescription, exercise prescription
Public URL http://researchrepository.napier.ac.uk/Output/3197335

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