Exercise medicine and public health

Background: In 2014 The National Institute for Health and Care Excellence (NICE) called for development of a system to collate local data on exercise referral schemes (ERS) to inform future practice. This database would be used to facilitate continued evaluation of ERS. ‘Big data’ analytics is a current trend in healthcare with the potential to influence decision making. Indeed, the use of health databases can spur scientific investigation and generation of evidence regarding healthcare practice. NICEs recommendation has not yet been met by public health bodies. However, through collaboration between ukactive, ReferAll, a specialist in software solutions for exercise referral, and the National Centre for Sport and Exercise Medicine, data has been collated from multiple UK based ERS to generate one of the largest databases of its kind and move towards meeting NICEs recommendation. Method: This paper describes the formation of The National Referral Database, its structure including outcome measures, data cleaning processes, and in two accompanying manuscripts the first initial observational insights are presented from analysis of this data. Results: Collating data from 19 ERSs on 24,086 individuals, a database has been created containing pre and post referral data for metrics including; physical activity, blood pressure, BMI, resting heart rate, SWEMWBS scores, ESES scores, WHO5 scores and ERQoL scores. After data cleaning processes there were 14 ERSs remaining covering 23,782 participants with an average age of 51±15 years and 68% of whom were female. Further, the database contains demographic information, reason for referral, medical conditions, and information on the referrer. Conclusion: This database has now been created and the initial data is available for researchers to interrogate. The National Referral Database represents a potentially valuable resource for the wider research community, as well as policy makers and practitioners in this area, which will facilitate a better understanding of ERS and other physical activity related social prescribing pathways to help inform public health policy and practice. Longer term plans include establishment of the database as an open resource, continually updated with additional data and version controls, for researchers to access for further research and policy makers and practitioners to use to inform their policies/practices.

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Evaluation of the Public Health England and Sport England Funded Physical Activity Clinical Advice Pad Pilot in Primary Care

10.31219/osf.io/st94m ◽

2020 ◽

Author(s):

Robert J. Copeland ◽

Anna Myers ◽

Helen Quirk ◽

Helen Crank ◽

David Broom ◽

...

Keyword(s):

Public Health ◽

Physical Activity ◽

The Public ◽

Telephone Interviews ◽

Exercise Medicine ◽

Independent Evaluation ◽

Innovative Work ◽

Sport And Exercise ◽

Brief Advice ◽

Improve Health

In 2014 Public Health England (PHE) launched the national physical activity (PA) framework ‘Everybody Active, Everyday’. The framework included a key domain for action called ‘Moving Professionals’. The Moving Professionals Programme aimed to build expertise and leadership across key professional sectors and to raise awareness and understanding of the health benefits of PA among professionals and the wider public. The Moving Professionals Programme comprised a number of innovative work packages that are described elsewhere (See Brannan et al., 2019). The Physical Activity Clinical Advice Pad (PACAP) pilot was one element of the Moving Professionals Programme, and aimed to; increase the number of primary healthcare professionals (HCPs) in England who integrate brief advice on PA into their routine clinical practice.The PACAP provides advice about the amount and type of PA required to improve health and was designed to look like a prescription pad to aid compliance with the advice provided. It also provides tips on different ways to become more active and signposts users to the PHE Active 10 app and One You website. The purpose of the PACAP was to prompt and facilitate conversations about PA between HCPs and patients.In 2017, PHE and Sport England invited expressions of interest (EoIs) from Local Authority (LA) and Clinical Commissioning Group (CCG) partnerships across England to engage in the pilot. Twenty-five applications were returned and ten partnerships were invited to take part in the PACAP pilot.As part of the National Centre for Sport and Exercise Medicine (NCSEM) network, academics at Sheffield Hallam University (SHU) were commissioned to conduct an independent evaluation of the PACAP pilot. The NCSEM were not responsible for the implementation or delivery of the PACAP pilot. The evaluation adopted a mixed methods approach to explore the acceptability of the PACAP pilot. Data was collected from patients and HCPs using surveys, telephone interviews, focus groups and audits between April 2018 and February 2019. This report details the evaluation findings, provides recommendation for future iterations of the project and provides implications for scaling the PACAP across additional localities in England.

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The National ReferAll Database: An Open Dataset of Exercise Referral Schemes Across the UK

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094831 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4831

Author(s):

James Steele ◽

Matthew Wade ◽

Robert J. Copeland ◽

Stuart Stokes ◽

Rachel Stokes ◽

...

Keyword(s):

Public Health ◽

Outcome Measures ◽

Research Community ◽

Research Centre ◽

Policy And Practice ◽

Local Data ◽

Exercise Medicine ◽

Sport And Exercise ◽

The Uk ◽

Exercise Referral

In 2014, The National Institute for Health and Care Excellence (NICE) called for the development of a system to collate local data on exercise referral schemes (ERS). This database would be used to facilitate continued evaluation of ERS. The use of health databases can spur scientific investigation and the generation of evidence regarding healthcare practice. NICE’s recommendation has not yet been met by public health bodies. Through collaboration between ukactive, ReferAll, a specialist in software solutions for exercise referral, and the National Centre for Sport and Exercise Medicine, which has its research hub at the Advanced Wellbeing Research Centre, in Sheffield, data has been collated from multiple UK-based ERS to generate one of the largest databases of its kind. This database moves the research community towards meeting NICEs recommendation. This paper describes the formation and open sharing of The National ReferAll Database, data-cleaning processes, and its structure, including outcome measures. Collating data from 123 ERSs on 39,283 individuals, a database has been created containing both scheme and referral level characteristics in addition to outcome measures over time. The National ReferAll Database is openly available for researchers to interrogate. The National ReferAll Database represents a potentially valuable resource for the wider research community, as well as policy makers and practitioners in this area, which will facilitate a better understanding of ERS and other physical-activity-related social prescribing pathways to help inform public health policy and practice.

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Evaluation of the Public Health England and Sport England Funded Sport and Exercise Medicine Pilot in Secondary Care

10.31219/osf.io/qtnjx ◽

2020 ◽

Author(s):

Robert J. Copeland ◽

Anna Myers ◽

Helen Quirk ◽

Helen Crank ◽

David Broom ◽

...

Keyword(s):

Public Health ◽

Clinical Pathways ◽

University Hospital ◽

Face To Face ◽

Telephone Interviews ◽

Care Plans ◽

Exercise Medicine ◽

Independent Evaluation ◽

Sport And Exercise ◽

The Uk

In 2014 Public Health England (PHE) launched the national physical activity (PA) framework ‘Everybody Active, Everyday’. The framework included a key domain for action called ‘Moving Professionals’. The Moving Professionals Programme aimed to build expertise and leadership across key professional sectors and to raise awareness and understanding of the health benefits of PA among professionals and the wider public. The Moving Professionals Programme comprised a number of innovative work packages that are described elsewhere (See Brannan et al., 2019). The Sport and Exercise Medicine (SEM) pilot was one element of the Moving Professionals Programme, and aimed to embed an SEM consultant led PA service within an NHS Trust to integrate PA in to the care plans of patients. This was termed creating an 'Active Hospital'.PHE and Sport England invited expressions of interest (EoIs) from NHS Trusts with the capacity to deliver the SEM pilot through a competitive process. Three Trusts were invited to interview and Oxford University Hospital NHS Foundation Trust (OUHFT) were selected to deliver the pilot. The successful Trust was tasked with developing an SEM pilot that strengthened existing core resources and expanded existing capacity to integrate specialist PA advice into the care pathways for adults in-patient care. This was tested across five clinical pathways within OUHFT where PA had not previously been targeted as a treatment intervention.Two lead SEM consultants were responsible for developing and implementing the SEM pilot, which targeted five clinical pathways and was underpinned by the COM-B model. These were; Maternity, Enablement, Renal, Complex Medical Unit (originally Critical Care), and Cardiology.As part of the National Centre for Sport and Exercise Medicine (NCSEM) network, academics at Sheffield Hallam University (SHU) were commissioned to conduct an independent evaluation of the SEM pilot. The NCSEM were not responsible for the implementation or delivery of the SEM pilot. The evaluation aimed to explore the acceptability and feasibility of the SEM pilot and followed a mixed methods approach. Data was collected from patients and healthcare professionals (HCPs) using surveys, face-to-face and telephone interviews and audits between June 2018 and March 2019. This report details the evaluation findings and provides implications for ongoing implementation of the pilot in OUHFT and for sharing learning with other Trusts across the UK.

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