Morgan Fiona, Battersby Alysia, Weightman Alison L, Searchfield Lydia, Turley Ruth, Morgan Helen, Jagroo James, Ellis Simon
Specialist Unit for Review Evidence (SURE), Cardiff University,1st Floor, Neuadd Meirionnydd, Heath Park Campus, Cardiff, CF14 4YS, UK.
National Institute for Health and Care Excellence, Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BD, UK.
BMC Public Health. 2016 Mar 5;16:227. doi: 10.1186/s12889-016-2882-7.
Physical inactivity levels are rising worldwide with major implications for the health of the population and the prevalence of non-communicable diseases. Exercise referral schemes (ERS) continue to be a popular intervention utilised by healthcare practitioners to increase physical activity. We undertook a systematic review of views studies in order to inform guidance from the UK National Institute of Health and Care Excellence (NICE) on exercise referral schemes to promote physical activity. This paper reports on the participant views identified, to inform those seeking to refine schemes to increase attendance and adherence.
Fifteen databases and a wide range of websites and grey literature sources were searched systematically for publications from 1995 to June 2013. In addition, a range of supplementary methods including, a call for evidence by NICE, contacting authors, reference list checking and citation tracking were utilised to identify additional research. Studies were included where they detailed schemes for adults aged 19 years or older who were 'inactive' (i.e. they are not currently meeting UK physical activity guidelines). Study selection was conducted independently in duplicate. Quality assessment was undertaken by one reviewer and checked by a second, with 20 % of papers being considered independently in duplicate. Papers were coded in qualitative data analysis software Atlas.ti. This review was reported in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement).
Evidence from 33 UK-relevant studies identified that support from providers, other attendees and family was an important facilitator of adherence and 'making exercise a habit' post programme, as was the variety and personalised nature of sessions offered. Barriers to attendance included the inconvenient timing of sessions, their cost and location. An intimidating gym atmosphere, a dislike of the music and TV and a lack of confidence in operating gym equipment were frequently reported.
These findings provide valuable insights that commissioners and providers should consider. The main themes were consistent across a large number of studies and further research should concentrate on programmes that reflect these findings.
全球范围内身体活动不足的情况日益严重，这对人群健康和非传染性疾病的流行产生了重大影响。运动转诊计划（ERS）仍然是医疗从业者用来增加身体活动的一种流行干预措施。我们进行了一项观点研究的系统评价，以便为英国国家卫生与临床优化研究所（NICE）关于运动转诊计划以促进身体活动的指南提供参考。本文报告了所确定的参与者观点，为那些寻求完善计划以提高参与率和依从性的人提供信息。
系统检索了15个数据库以及大量网站和灰色文献来源，以查找1995年至2013年6月期间的出版物。此外，还采用了一系列补充方法，包括NICE的证据征集、联系作者、参考文献列表检查和引文跟踪，以识别其他研究。纳入的研究详细描述了针对19岁及以上“不活跃”（即目前未达到英国身体活动指南）成年人的计划。研究选择由两人独立进行。质量评估由一名评审员进行，另一名评审员进行检查，20%的论文由两人独立进行重复评估。论文在定性数据分析软件Atlas.ti中进行编码。本评价按照PRISMA（系统评价和Meta分析的首选报告项目声明）进行报告。
来自33项与英国相关研究的证据表明，提供者、其他参与者和家人的支持是计划结束后坚持锻炼并“养成锻炼习惯”的重要促进因素，所提供课程的多样性和个性化性质也是如此。参与的障碍包括课程时间不方便、费用和地点。经常有人报告健身房氛围令人生畏、不喜欢音乐和电视以及对操作健身器材缺乏信心。
这些发现提供了有价值的见解，委托方和提供方应予以考虑。大量研究中的主要主题是一致的，进一步的研究应集中在反映这些发现的计划上。
