The systematic identification of content and delivery style of an exercise intervention

Abstract

Objective: This study explored the utility of using behaviour change taxonomies and checklists to systematically assess the content and delivery of behavioural support for physical activity delivered through an established exercise-referral scheme.

Design: An observation study was conducted whereby 22% of initial consultations were observed and audio-recorded, using quota sampling stratified by exercise-referral advisor.

Main outcome measures: Content was independently coded by two researchers, to assess; (i) completeness in delivering the programme protocol, (ii) behaviour change techniques delivered (defined using the CALO-RE taxonomy) and (iii) delivery style according to the Behaviour Change Counselling Index (BECCI).

Results: Protocol completeness was 63.6% (range 35.6–74.6%). The behaviour change techniques delivered most consistently were ‘providing information about where and when to perform the behavior’ (86%) and ‘setting outcome goals’ (82%). Other evidence-based techniques such as self-monitoring were infrequently observed. Variation in BECCI scores indicated that advisors could, but did not consistently, provide a client-centred service.

Conclusion: This study highlights how theoretically informed taxonomies can be useful in evaluating service delivery within applied practice, providing a meaningful way of assessing the completeness of protocol delivery relative to evidence. The provision of feedback to practitioners based on such objective criteria also facilitated positive academic-practitioner communication.

Keywords:

• exercise referral
• evaluation
• behaviour change taxonomies
• observational study
• physical activity

Acknowledgements

We would like to thank all of the Passport to Health advisors and clients for participating in this study.

Competing interests

None

Funding

This work was funded by a Knowledge Transfer Fellowship supported by Bath and North East Somerset Council, Bath and North East Somerset Public Health Directorate (former PCT), and the Higher Education Innovations Fund.

Supplemental data

Supplemental data for this article can be accessed here: http://dx.doi.org/10.1080/08870446.2015.1132718.

Disclosure statement

No potential conflict of interest was reported by the authors.