scholarly journals Exercise Referral Instructors’ Perspectives on Supporting and Motivating Participants to Uptake, Attend and Adhere to Exercise Prescription: A Qualitative Study

2021 ◽  
Vol 19 (1) ◽  
pp. 203
Author(s):  
Colin B. Shore ◽  
Stuart D. R. Galloway ◽  
Trish Gorely ◽  
Angus M. Hunter ◽  
Gill Hubbard
Keyword(s):  
Qualitative Study ◽  
Peer Support ◽  
Behaviour Change ◽  
Exercise Prescription ◽  
Structured Interviews ◽  
Non Communicable Diseases ◽  
Leisure Services ◽  
Exercise Referral ◽  
Exercise Referral Scheme ◽  
Improve Health

Exercise referral schemes are designed to support people with non-communicable diseases to increase their levels of exercise to improve health. However, uptake and attendance are low. This exploratory qualitative study aims to understand uptake and attendance from the perspectives of exercise referral instructors using semi-structured interviews. Six exercise referral instructors from one exercise referral scheme across four exercise referral sites were interviewed. Four themes emerged: (i) the role that instructors perceive they have and approaches instructors take to motivate participants to take-up, attend exercise referral and adhere to their exercise prescription; (ii) instructors’ use of different techniques, which could help elicit behaviour change; (iii) instructors’ perceptions of participants’ views of exercise referral schemes; and (iv) barriers towards providing an exercise referral scheme. Exercise referral instructors play an important, multifaceted role in the uptake, attendance and adherence to exercise referral. On-going education and peer support for instructors may be useful. Instructors’ perspectives help us to further understand how health and leisure services can design successful exercise referral schemes.

scholarly journals Integration of Motivational Interviewing into Practice in the National Exercise Referral Scheme in Wales: A Mixed Methods Study

2011 ◽  
Vol 40 (3) ◽  
pp. 313-330 ◽  
Author(s):  
Graham F. Moore ◽  
Laurence Moore ◽  
Simon Murphy
Keyword(s):  
Motivational Interviewing ◽  
Behaviour Change ◽  
Current Practice ◽  
Data Gathering ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Behaviour Change Counselling ◽  
Before And After ◽  
Exercise Referral ◽  
Exercise Referral Scheme

Background: Though motivational interviewing (MI) has demonstrated efficacy in a range of behaviour change settings, effectiveness will require successful integration into everyday practice. This study examines implementers’ views on delivering MI within an exercise referral scheme and consistency of consultations with MI before and after a 2-day workshop. Method: Semi-structured interviews were conducted with 27 exercise professionals and 10 area coordinators delivering the Welsh National Exercise Referral Scheme (NERS), and the MI trainer. Eleven professionals provided consultation recordings before and 6-months after training, coded for fidelity using the Behaviour Change Counselling Index. Results: The workshop was well received by most, triggering increased recognition of potential motivational roles of consultations. However, some cited difficulties combining MI with structured data gathering activities, whilst a minority rejected MI, seeing current practice as effective, or MI as unnecessary because patients were ready to change. Although limited aggregate improvement in practice was observed, substantial improvements were observed in some individuals. Comments on the need for further practice or training were widespread. Conclusions: Efforts to implement MI should ensure that training and structures to provide monitoring and feedback are in place and that activities incorporated within consultations are compatible with MI delivery.

scholarly journals A qualitative study of adolescent and young adult cancer survivors’ perceptions of family and peer support

2018 ◽  
Vol 25 (5) ◽  
pp. 713-726 ◽  
Author(s):  
Glynnis A McDonnell ◽  
Elyse Shuk ◽  
Jennifer S Ford
Keyword(s):  
Young Adult ◽  
Qualitative Study ◽  
Peer Support ◽  
Adult Survivors ◽  
Adolescent And Young Adult ◽  
Structured Interviews ◽  
Young Adult Cancer Survivors ◽  
Practical Support ◽  
Adult Cancer Survivors ◽  
Young Adult Survivors

This qualitative study examined adolescent and young adult survivors’ perceptions of support from family and peers. A total of 26 survivors, aged 16–24 years, who had been diagnosed with cancer between the ages of 14 and 18, participated in semi-structured interviews. Three themes emerged for support: practical support, emotional support, and new sense of closeness. For lack of support, two themes emerged: absence during treatment and lack of understanding about appearance changes. These findings emphasize the perceived importance of family and peer support throughout adolescent and young adults’ cancer trajectories and indicate a need for interventions to help adolescent and young adult develop and maintain support networks throughout treatment and survivorship.

scholarly journals Factors influencing patient uptake of an exercise referral scheme: a qualitative study

2018 ◽  
Vol 34 (1) ◽  
pp. 113-127 ◽  
Author(s):  
S B Birtwistle ◽  
G Ashcroft ◽  
R Murphy ◽  
I Gee ◽  
H Poole ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Factors Influencing ◽  
Exercise Referral ◽  
Exercise Referral Scheme

scholarly journals Multi-Stakeholder Retrospective Acceptability of a Peer Support Intervention for Exercise Referral

2021 ◽  
Vol 18 (4) ◽  
pp. 1720
Author(s):  
Robert M. Portman ◽  
Andrew R. Levy ◽  
Anthony J. Maher ◽  
Stuart J. Fairclough
Keyword(s):  
Social Support ◽  
Peer Support ◽  
Perceived Social Support ◽  
Cost Effective ◽  
Structured Interviews ◽  
Support Intervention ◽  
Peer Volunteers ◽  
Multi Stakeholder ◽  
Exercise Referral ◽  
Peer Support Intervention

Perceived social support opportunities are central to successful exercise referral scheme (ERS) client experiences. However, there remains a lack of guidance on how ERSs can embed social support opportunities within their provision. This study presents retrospective acceptability findings from a 12-week social-identity-informed peer support intervention to enhance perceived social support among clients of an English ERS. Five peer volunteers were recruited, trained, and deployed in supervised ERS sessions across two sites. Peers assisted exercise referral officers (EROs) by providing supplementary practical, informational, motivational, and emotional support to ERS clients. Individual semi-structured interviews were conducted with peers (n = 4), EROs (n = 2), and clients (n = 5) and analysed thematically. The analysis identified three primary themes. The first theme detailed how EROs utilised peer volunteers to supplement the ERS client experience. This theme delineated peer roles within the ERS context and identified salient individual peer characteristics that contributed to their success. The second theme described peer acceptability among the various stakeholders. Peers were valued for their ability to reduce burden on EROs and to enhance perceptions of comfort among ERS clients. The final theme presented participant feedback regarding how the intervention may be further refined and enhanced. Peers represented a cost-effective and acceptable means of providing auxiliary social support to ERS clients. Moving forward, the structured integration of peers can improve the accessibility of social support among ERS participants, thus facilitating better rates of ERS completion.

scholarly journals From a research trial to routine practice: stakeholders’ perceptions and experiences of referrals to the National Exercise Referral Scheme (NERS) in Wales

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kelly Morgan ◽  
Jennifer Lewis ◽  
Jemma Hawkins ◽  
Graham Moore
Keyword(s):  
Controlled Trial ◽  
Patient Characteristics ◽  
Routine Practice ◽  
Structured Interviews ◽  
Effective Interventions ◽  
Included Patient ◽  
Perceived Effects ◽  
Randomised Controlled ◽  
Exercise Referral ◽  
Exercise Referral Scheme

Abstract Background Over ten years on from a randomised controlled trial and subsequent national roll-out, the National Exercise Referral Scheme (NERS) continues to be routinely delivered in primary care across Wales, UK. Few studies have revisited effective interventions years into their delivery in routine practice to understand how implementation, and perceived effects, have been maintained over time. This study explores perceptions and experiences of referral to NERS among referrers, scheme deliverers and patients. Methods Individual, semi-structured interviews were conducted with 50 stakeholders: scheme referrers (n = 9); scheme deliverers (n = 22); and referred patients (n = 19). Convenience sampling techniques were used to recruit scheme referrers and purposive sampling to recruit scheme deliverers and patients. Thematic analysis was employed. Results Analyses resulted in five key themes; referrer characteristics, geographical disparities in referral and scheme access, reinforcements for awareness of the scheme, patient characteristics and processes and context underpinning a referral. Overall there was a high concordance of views between all three stakeholder groups and barriers and facilitators were found to be entwined within and across themes. Referral barriers persisting since the earlier trial included a lack of consultation time and a lack of referral feedback. Newly identified barriers included a lack of scheme awareness and a referral system perceived to be time intensive and disjointed. Key referral facilitators included patient self-referrals, a growing scheme reputation and promotional activities of scheme deliverers. Conclusions Findings provide evidence that could inform the further development of NERS and wider exercise referral schemes to ensure the referral process is timely, efficient and equitable.

scholarly journals The match between what is prescribed and reasons for prescribing in exercise referral schemes: a mixed method study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Colin B. Shore ◽  
Gill Hubbard ◽  
Trish Gorely ◽  
Angus M. Hunter ◽  
Stuart D. Galloway
Keyword(s):  
Qualitative Data ◽  
Exercise Prescription ◽  
Communicable Disease ◽  
Moderate Intensity ◽  
Activity Levels ◽  
Structured Interviews ◽  
Different Types ◽  
Perceived Outcomes ◽  
Exercise Referral ◽  
Non Communicable Disease

Abstract Background Exercise referral schemes (ERS) aim to tackle non-communicable disease (NCD) by increasing physical activity levels through prescribed exercise. However, there is a sparsity of knowledge upon what exercises are prescribed and if they are targeted towards tackling NCD. Method Mixed methods were employed. Quantitative data was extracted from exercise prescription cards of 50 participants and were assessed for frequency, intensity, type and time of prescribed exercise. Descriptive measures of aggregate data are expressed as median (range: minimum-maximum). Thematic analysis of semi-structured interviews generated qualitative data on exercise referral instructors’ experiences of prescribing exercise. Results Thirty-eight different types of exercise were prescribed. Median prescription was 4 (1–11) exercises per session, at a moderate intensity. Participants were prescribed a median of 35 (5–70) minutes of aerobic exercise per referral session. Exercise referral instructors prescribed exercise to improve activities of daily living, promote independence and autonomy of participants, rather than explicitly targeting the referral condition. Conclusions Knowledge that prescribed exercises are not explicitly targeted to the referral condition provides critical information in understanding the purpose of exercise prescription. Future evaluations of ERS should be mindful of this, that is, perceived outcomes might not match up to what is being prescribed within ERS.

scholarly journals Peer support workers as a bridge: a qualitative study exploring the role of peer support workers in the care of people who use drugs during and after hospitalization

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Robin Lennox ◽  
Larkin Lamarche ◽  
Tim O’Shea
Keyword(s):  
Qualitative Study ◽  
Peer Support ◽  
Healthcare Providers ◽  
People Who Use Drugs ◽  
Healthcare Team ◽  
Structured Interviews ◽  
Support Worker ◽  
Team Members ◽  
Key Stakeholders

Abstract Background To describe the key qualities and unique roles of peer support workers in the care of people who inject drugs during and after hospitalization. Methods We conducted a qualitative study. Key stakeholders were recruited including: people who use drugs who had been hospitalized, healthcare team members, peer support workers, and employers of peer support workers. Data were collected from 2019 to 2020 using semi-structured interviews that were audio-recorded, transcribed, and analyzed thematically. Results Fourteen participants were interviewed: 6 people who use drugs who had been hospitalized, 5 healthcare team members, 2 peer support workers, and 1 employer of peer support workers. At the core of the data was the notion of peer workers acting as a bridge. We found four themes that related to functions of this bridge: overcoming system barriers, advocacy, navigating transitions within the healthcare system, and restoring trust between HCPs and PWUD. We found two themes for building a strong bridge and making the role of a peer support worker function effectively (training and mentorship, and establishing boundaries). We found three themes involving characteristics of an effective peer worker (intrinsic qualities, contributions of shared experiences, and personal stability). Conclusion Peer support workers are highly valued by both people who use drugs and members of the healthcare team. Peer support workers act as a bridge between patients and healthcare providers and are critical in establishing trust, easing transitions in care, and providing unique supports to people who use drugs during and after hospitalization.

scholarly journals Evaluation of a tactic to engage hard-to-reach patients during the exercise referral process: a longitudinal qualitative study

2015 ◽  
Vol 3 (3) ◽  
pp. 288
Author(s):  
Martyn Queen ◽  
Diane Crone ◽  
Andrew Parker
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Qualitative Study ◽  
Physical Activity Intervention ◽  
Health Centre ◽  
Referral Process ◽  
Structured Interviews ◽  
Primary Care Health ◽  
The Subject ◽  
Exercise Referral

Objectives General practitioners (GPs) have been reluctant to promote physical activity with overweight and obese patients, due to concerns about damaging the GP patient relationship. A longitudinal qualitative study was conducted to evaluate a small group of health professionals (HPs) and their patients’ perspectives of the referral process for exercise in a Primary Care setting.Methods 12 patients aged 55-74 and their 6 referring HPs, including 5 GPs and 1 Practice Nurse. Semi-structured interviews took place on two occasions over an 8 month period in a Primary Care Health Centre. Transcripts of recorded interviews were coded and thematically analysed using a grounded theory approach.Results HPs and patients identified difficulties associated with broaching the subject of obesity. HPs identified that tensions could arise when discussing weight management and exercise. Patients identified disliking the way that their HP had introduced the subject of obesity and the need for physical activity. The patients later acknowledged that the consultation where a direct approach was used (shock tactic), was the motivation necessary to engage them with the exercise referral scheme.Conclusion Shock tactics by HPs can be an effective method of engaging hard-to-reach patients with a physical activity intervention. NHS service commissioners should consider training HPs to identify and engage patients that would benefit from such an approach.

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