Exercise, service and support: client experiences of physical activity referral schemes (PARS)

Abstract

Physical activity referral schemes (PARS) represent one of the most prevalent interventions in the fight against chronic illness such as coronary heart disease and obesity. Despite this, issues surrounding low retention and adherence continue to hinder the potential effectiveness of such schemes on public health. This article reports on the second stage of a larger investigation into client experiences of PARS focusing specifically on findings from five client-based focus groups and interviews with five Scheme Organisers. The resulting analysis reveals three main factors impacting participant perceptions of the quality of service and support received: the organisation of PARS provision, client engagement with the PARS community and the nature and extent of client support networks. The article demonstrates that staff have a considerable role to play in engaging clients in the PARS system and that Scheme Organisers should give serious thought to ensuring that clients have valuable and sustainable networks of support. Furthermore, it is suggested that Scheme Organisers need to facilitate a system in which staff are genuinely engaged with the needs of clients and are able to provide individualised programmes of physical activity.

Keywords:

• physical activity
• referral schemes
• qualitative
• exercise
• adherence

Notes

1. In order to preserve anonymity, pseudonyms have been used throughout.

2. REFERQUAL is a bespoke adaptation of the SERVQUAL instrument (Parasuraman et al. 1988) for evaluating service quality in PARS. Further details of this instrument including the study investigating the reliability of the tool can be found in Cock et al. (2006).

3. Whilst recognising the dangers of essentialising respondent accounts, we have chosen to present our analysis in this way because these were the predominant themes which emerged from the qualitative data-collection process. In turn, these categories allow us to demonstrate more fully potential barriers to PARS adherence.

4. Phase 3 refers to the third stage of cardiac rehabilitation which comprises structured physical activity programming under medical supervision. When patients ‘graduate’ from Phase 3, they often attend PARS as Phase 4 of their treatment and rehabilitation.