title: Assessing the feasibility of using uniaxial accelerometers with an online support platform in the delivery of a community-based exercise referral scheme.
abstract: Exercise referral schemes are established within community-based health care; however, they have been criticized for failing to evidence long-term behavior change relative to usual care. As such, recent reviews have called for refinement of their delivery with a focus on embedded strategies targeting client motivation. This research letter presents findings from an initial pilot trial conducted within Wales' National Exercise Referral Scheme (NERS), examining the feasibility of using validated physical activity monitoring devices and an accompanying online platform within standard scheme delivery. 30 individuals referred to generic or cardiovascular pathways were offered the system; of these 17 agreed to participate. Common reasons for declining were clustered into lack of technology literacy or access, condition severity, or fear of costs associated with losing the device. Analysis of follow-up interviews after 4 weeks of use indicated that while participants found the monitoring devices practical and informative, only a minority (n = 4) were using the system in full. Crucially, the system element most aligned with contemporary theories of motivation (the online portal) was not used as expected. In addition, feedback from exercise referral professionals indicated that there were demands for support from clients, which might be mitigated by more effective independent system use. Recommendations for larger scale trials using similar systems include consideration of targeted patient groups, equity of access, and providing adequate technological support that is currently beyond the capacity of the NERS system.
authors.affiliation: Cardiff University, Cardiff, UK hawkinsj10@cardiff.ac.uk.
authors.forename: Jemma L
authors.initials: JL
authors.lastname: Hawkins
authors.affiliation: Durham University, Durham, UK.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Oliver
authors.affiliation: National Exercise Referral Scheme Coordinator for Wales, Welsh Local Government Association, Cardiff, UK.
authors.forename: Jeannie
authors.initials: J
authors.lastname: Wyatt-Williams
authors.affiliation: National Exercise Referral Scheme, Coordinator for Pembrokeshire, Milford Haven Leisure Centre, Milford Haven, UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Scale
authors.affiliation: Public Health Wales, Cardiff, UK.
authors.forename: Hugo C
authors.initials: HC
authors.lastname: van Woerden
mesh_terms: D061725:Accelerometry / Q000295:instrumentation*; D000368:Aged; D003153:Community Health Services / Q000458:organization & administration*; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010865:Pilot Projects; D012944:Social Support; D014852:Wales
keywords: accelerometer; exercise referral; motivation; physical activity; telehealth