Evaluation of a standard provision versus an autonomy promotive exercise referral programme: rationale and study design

Kate Jolly,Joan L Duda,Geoffrey C Williams,Peter C Rouse,Rekha Lodhia,Nikos Ntoumanis,Amanda Daley,Frank F Eves,Nanette Mutrie

doi:10.1186/1471-2458-9-176

Abstract

BackgroundThe National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT)-based exercise referral consultation.Methods/DesignDesign: An exploratory cluster randomised controlled trial comparing standard provision exercise on prescription with a Self Determination Theory-based (SDT) exercise on prescription intervention.Participants: 347 people referred to the Birmingham Exercise on Prescription scheme between November 2007 and July 2008. The 13 exercise on prescription sites in Birmingham were randomised to current practice (n = 7) or to the SDT-based intervention (n = 6).Outcomes measured at 3 and 6-months: Minutes of moderate or vigorous physical activity per week assessed using the 7-day Physical Activity Recall; physical health: blood pressure and weight; health status measured using the Dartmouth CO-OP charts; anxiety and depression measured by the Hospital Anxiety and Depression Scale and vitality measured by the subjective vitality score; motivation and processes of change: perceptions of autonomy support from the advisor, satisfaction of the needs for competence, autonomy, and relatedness via physical activity, and motivational regulations for exercise.DiscussionThis trial will determine whether an exercise referral programme based on Self Determination Theory increases physical activity and other health outcomes compared to a standard programme and will test the underlying SDT-based process model (perceived autonomy support, need satisfaction, motivation regulations, outcomes) via structural equation modelling.Trial registrationThe trial is registered as Current Controlled trials ISRCTN07682833.

Highlights

The National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials
This trial will determine whether an exercise referral programme based on Self Determination Theory increases physical activity and other health outcomes compared to a standard programme and will test the underlying SDT-based process model via structural equation modelling
This review identified six randomised controlled trials (RCTs) comparing an exercise referral scheme with usual care as well as using the findings from other study designs to estimate drop-out rates from these schemes

Summary

Introduction

Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT)-based exercise referral consultation. Recent US government guidelines have distinguished between the minutes per week required as a function of whether the physical activity is moderate or of high intensity [11], Haskell and colleagues have recommended the minimum frequency and duration of moderate to vigorous physical activity necessary to gain such health benefits. In an attempt to increase physical activity levels in the general population, a range of interventions have been developed and implemented and systematic review suggests that interventions that are theory driven and use a counselling style to change behaviour have evidence of successful behaviour change [14]

Methods

Results

Conclusion