Effects of a standard provision versus an autonomy supportive exercise referral programme on physical activity, quality of life and well-being indicators : a cluster randomised controlled trial

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@article{e31f459fe4de4d29b51b954c67a91f6b,
title = "Effects of a standard provision versus an autonomy supportive exercise referral programme on physical activity, quality of life and well-being indicators : a cluster randomised controlled trial",
abstract = "BackgroundThe National Institute for Health and Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the feasibility and impact of a Self Determination Theory-based (SDT) exercise referral consultation.MethodsAn exploratory cluster randomised controlled trial comparing standard provision exercise referral with an exercise referral intervention grounded in Self Determination Theory. Individuals (N = 347) referred to an exercise referral scheme were recruited into the trial from 13 centres.Outcomes and processes of change measured at baseline, 3 and 6-months: Minutes of self-reported moderate or vigorous physical activity (PA) per week (primary outcome), health status, positive and negative indicators of emotional well-being, anxiety, depression, quality of life (QOL), vitality, and perceptions of autonomy support from the advisor, need satisfaction (3 and 6 months only), intentions to be active, and motivational regulations for exercise.Blood pressure and weight were assessed at baseline and 6 months.ResultsPerceptions of the autonomy support provided by the health and fitness advisor (HFA) did not differ by arm. Between group changes over the 6-months revealed significant differences for reported anxiety only. Within arm contrasts revealed significant improvements in anxiety and most of the Dartmouth CO-OP domains in the SDT arm at 6 months, which were not seen in the standard exercise referral group. A process model depicting hypothesized relationships between advisor autonomy support, need satisfaction and more autonomous motivation, enhanced well being and PA engagement at follow up was supported.ConclusionsSignificant gains in physical activity and improvements in quality of life and well-being outcomes emerged in both the standard provision exercise referral and the SDT-based intervention at programme end. At 6-months, observed between arm and within intervention arm differences for indicators of emotional health, and the results of the process model, were in line with SDT. The challenges in optimising recruitment and implementation of SDT-based training in the context of health and leisure services are discussed.Trial registrationThe trial is registered as Current Controlled trials ISRCTN07682833.",
keywords = "Exercise on referral, Physical activity promotion, Self determination theory, Autonomy support, Autonomous motivation, Need satisfaction, Subjective vitality, Dartmouth CO-OP charts",
author = "Duda, {Joan L} and Williams, {Geoffrey C} and Nikos Ntoumanis and Amanda Daley and Eves, {Frank F} and Nanette Mutrie and Rouse, {Peter C} and Rekha Lodhia and Ruth Pritchett and Catherine Jolly",
year = "2014",
month = jan,
day = "24",
doi = "10.1186/1479-5868-11-10",
language = "English",
volume = "11",
journal = "The International Journal of Behavioral Nutrition and Physical Activity",
issn = "1479-5868",
publisher = "BioMed Central",
number = "10",

}

RIS

TY - JOUR

T1 - Effects of a standard provision versus an autonomy supportive exercise referral programme on physical activity, quality of life and well-being indicators : a cluster randomised controlled trial

AU - Duda, Joan L

AU - Williams, Geoffrey C

AU - Ntoumanis, Nikos

AU - Daley, Amanda

AU - Eves, Frank F

AU - Mutrie, Nanette

AU - Rouse, Peter C

AU - Lodhia, Rekha

AU - Pritchett, Ruth

AU - Jolly, Catherine

PY - 2014/1/24

Y1 - 2014/1/24

N2 - BackgroundThe National Institute for Health and Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the feasibility and impact of a Self Determination Theory-based (SDT) exercise referral consultation.MethodsAn exploratory cluster randomised controlled trial comparing standard provision exercise referral with an exercise referral intervention grounded in Self Determination Theory. Individuals (N = 347) referred to an exercise referral scheme were recruited into the trial from 13 centres.Outcomes and processes of change measured at baseline, 3 and 6-months: Minutes of self-reported moderate or vigorous physical activity (PA) per week (primary outcome), health status, positive and negative indicators of emotional well-being, anxiety, depression, quality of life (QOL), vitality, and perceptions of autonomy support from the advisor, need satisfaction (3 and 6 months only), intentions to be active, and motivational regulations for exercise.Blood pressure and weight were assessed at baseline and 6 months.ResultsPerceptions of the autonomy support provided by the health and fitness advisor (HFA) did not differ by arm. Between group changes over the 6-months revealed significant differences for reported anxiety only. Within arm contrasts revealed significant improvements in anxiety and most of the Dartmouth CO-OP domains in the SDT arm at 6 months, which were not seen in the standard exercise referral group. A process model depicting hypothesized relationships between advisor autonomy support, need satisfaction and more autonomous motivation, enhanced well being and PA engagement at follow up was supported.ConclusionsSignificant gains in physical activity and improvements in quality of life and well-being outcomes emerged in both the standard provision exercise referral and the SDT-based intervention at programme end. At 6-months, observed between arm and within intervention arm differences for indicators of emotional health, and the results of the process model, were in line with SDT. The challenges in optimising recruitment and implementation of SDT-based training in the context of health and leisure services are discussed.Trial registrationThe trial is registered as Current Controlled trials ISRCTN07682833.

AB - BackgroundThe National Institute for Health and Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the feasibility and impact of a Self Determination Theory-based (SDT) exercise referral consultation.MethodsAn exploratory cluster randomised controlled trial comparing standard provision exercise referral with an exercise referral intervention grounded in Self Determination Theory. Individuals (N = 347) referred to an exercise referral scheme were recruited into the trial from 13 centres.Outcomes and processes of change measured at baseline, 3 and 6-months: Minutes of self-reported moderate or vigorous physical activity (PA) per week (primary outcome), health status, positive and negative indicators of emotional well-being, anxiety, depression, quality of life (QOL), vitality, and perceptions of autonomy support from the advisor, need satisfaction (3 and 6 months only), intentions to be active, and motivational regulations for exercise.Blood pressure and weight were assessed at baseline and 6 months.ResultsPerceptions of the autonomy support provided by the health and fitness advisor (HFA) did not differ by arm. Between group changes over the 6-months revealed significant differences for reported anxiety only. Within arm contrasts revealed significant improvements in anxiety and most of the Dartmouth CO-OP domains in the SDT arm at 6 months, which were not seen in the standard exercise referral group. A process model depicting hypothesized relationships between advisor autonomy support, need satisfaction and more autonomous motivation, enhanced well being and PA engagement at follow up was supported.ConclusionsSignificant gains in physical activity and improvements in quality of life and well-being outcomes emerged in both the standard provision exercise referral and the SDT-based intervention at programme end. At 6-months, observed between arm and within intervention arm differences for indicators of emotional health, and the results of the process model, were in line with SDT. The challenges in optimising recruitment and implementation of SDT-based training in the context of health and leisure services are discussed.Trial registrationThe trial is registered as Current Controlled trials ISRCTN07682833.

KW - Exercise on referral

KW - Physical activity promotion

KW - Self determination theory

KW - Autonomy support

KW - Autonomous motivation

KW - Need satisfaction

KW - Subjective vitality

KW - Dartmouth CO-OP charts

U2 - 10.1186/1479-5868-11-10

DO - 10.1186/1479-5868-11-10

M3 - Article

C2 - 24475766

VL - 11

JO - The International Journal of Behavioral Nutrition and Physical Activity

JF - The International Journal of Behavioral Nutrition and Physical Activity

SN - 1479-5868

IS - 10

M1 - 10

ER -