Do general practices provide equitable access to physical activity interventions?
BACKGROUND
Exercise referral schemes are widespread across England. National guidance emphasises the need to engage groups that are disadvantaged.


OBJECTIVE
To examine the influence of socioeconomic deprivation on referral to, and use of, exercise referral schemes.


METHODS
Cross-sectional analysis of patients referred by general practices to exercise referral schemes between 2004 and 2006.


METHODS
Six primary care trusts (PCTs) in Greater London.


METHODS
Routine data about patients who had been referred to exercise referral schemes were used to estimate risk ratios for referral by general practice deprivation quintile, odds ratios (ORs) for uptake, and ORs for completion of exercise referral schemes by patients' deprivation status quintile.


RESULTS
All 317 general practices in the six PCTs were included in the referral analysis. Referrals were less likely from general practices serving advantaged socioeconomic areas (adjusted risk ratio for trend across deprivation quintiles 0.84; 95% confidence interval [CI] = 0.76 to 0.93). This study found no association between patients' deprivation status and their likelihood of taking up (adjusted OR, least versus most deprived quintile 1.05; 95% CI = 0.83 to 1.33) or completing the scheme (adjusted OR 1.23; 95% CI = 0.84 to 1.79).


CONCLUSIONS
General practices within areas of deprivation were more likely to refer patients to exercise referral schemes than practices in more advantaged areas. Once referred, it was found that patients living in areas of deprivation were as likely to take up and to complete the scheme as those living in more advantaged locations. Research is needed to identify the organisational and contextual factors that allow this pattern of service delivery, which appears to facilitate access to care among patients who live in areas of deprivation.
Sowden
Sarah L
SL
Department of Epidemiology and Public Health, University College London. s.sowden@ucl.ac.uk
Breeze
Elizabeth
E
Barber
Julie
J
Raine
Rosalind
R
D003430:Cross-Sectional Studies; D015444:Exercise; D005194:Family Practice / Q000191:economics* / Q000592:standards; D006293:Health Promotion / Q000379:methods; D006297:Health Services Accessibility / Q000191:economics* / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000592:standards; D012017:Referral and Consultation / Q000191:economics* / Q000592:standards / Q000706:statistics & numerical data; D012959:Socioeconomic Factors