A 3-month evaluation of the standard provision and a self-determination theory-based exercise on referral program

Exercise on referral schemes were developed in the UK to help sedentary people with at least one risk factor for CVD become more healthy by increasing their physical activity. However, there is only limited evidence concerning the effectiveness of such programs. In an exploratory cluster randomized controlled trial, 13 leisure centers offering exercise on referral were randomized to current practice or to an intervention condition grounded in self-determination theory (Deci & Ryan, 2000) and associated work on autonomysupportive health care counseling (e.g., Williams et al., 2006). At baseline and 3 months, 347 participants completed assessments of self-reported physical activity (Physical Activity Recall, or PAR), physical health, and well-being/quality of life (Dartmouth Co-Op Charts, the Hospital Anxiety and Depression Scale, and the Subjective Vitality Scale). The majority (72.9%) of the participants were female and either overweight or obese (90.3%) and 28.3% were from a non-white U.K. ethnic group. Overall, 67.2% reported doing less than the government recommendation of 150 min of moderate physical activity each week. At 3 months, 68.6% of those recruited undertook the PAR over the telephone and 157 participants returned a questionnaire (45.2%). Participants in the standard provision arm exhibited a significant increase in subjective vitality and minutes of self-reported moderate or vigorous physical activity while levels of anxiety and depression fell significantly. Significant improvements in perceived physical fitness, and change in health and overall health were also found. Parallel effects emerged for participants in the SDT-based arm; however, these individuals also exhibited significant increases in mood state, the perceived capacity to do daily activities, and overall quality of life. The observed differences, if sustained, would result in clinically significant health benefits. A 6-month follow-up of study participants is planned.