Newby, K;
Howlett, N;
Wagner, AP;
Lloyd, N;
Freethy, I;
Bontoft, C;
Fakoya, O;
... Brown, KE; + view all
(2025)
Adaptations to the welsh national exercise referral scheme during the COVID-19 pandemic: a qualitative study exploring the experiences of service users and providers and supplementary out-of-pocket cost analysis.
BMC Public Health
, 25
, Article 406. 10.1186/s12889-025-21502-3.
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Abstract
BACKGROUND: Despite the proliferation of exercise referral schemes in the UK, evidence on their efficacy is equivocal. The Welsh National Exercise Referral Scheme (NERS) is heavily used but inequalities in uptake have been reported. As a result of the COVID-19 pandemic, NERS was initially suspended and then transitioned from standard face-to-face delivery to alternative remote methods, including virtual delivery. The aim of this study was to explore the barriers and facilitators to uptake and engagement of NERS when delivered in face-to-face and virtual formats, and to examine the cost to service users of engaging with the scheme in these different ways. METHODS: This was a qualitative study with supplementary cost analysis. Maximum variation sampling was used to recruit participants. Interviews with service users (n = 21) and one person who declined the service, and three focus groups with service providers (n = 19), were conducted. Framework analysis was used to analyse the qualitative data. Quantitative data obtained through the interviews on service users’ out-of-pocket costs of attending face-to-face or virtual classes were summarised using descriptive statistics. RESULTS: Five themes were identified from the qualitative analysis which summarised barriers and facilitators to uptake and engagement as perceived and experienced by the different stakeholders. Themes included: opaqueness and uncertainty around referral; Exercise Referral Professionals allaying concerns and providing reassurance at scheme entry; the mixed appeal and accessibility of virtual delivery; factors that support ongoing engagement; and personal and financial circumstances restricting uptake and engagement. CONCLUSIONS: This study indicates that offering a virtual version of NERS could make the scheme more accessible to those who are typically underserved, provided strategies to address digital inclusion are addressed. Findings provide wider evidence to inform adaptations that could be made to ensure that other exercise referral schemes can optimise virtual delivery.
| Type: | Article |
|---|---|
| Title: | Adaptations to the welsh national exercise referral scheme during the COVID-19 pandemic: a qualitative study exploring the experiences of service users and providers and supplementary out-of-pocket cost analysis |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s12889-025-21502-3 |
| Publisher version: | https://doi.org/10.1186/s12889-025-21502-3 |
| Language: | English |
| Additional information: | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Physical activity, Exercise referral, Uptake, Adherence, Cost |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10207506 |
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