Title: GPARTS 2012- dr Christine Rea
Funder: Health and Social Care Research and Development Division (HSC R&D) of Public Health Agency, Northern Ireland

Abstract: Aims and Purpose: Whilst there is a lack of robust evidence regarding the effectiveness of exercise referral schemes and their various components, investment is being made, aiming to make these schemes better. This project aims to explore GPs’ referral patterns in Northern Ireland and their views on exercise referral schemes, including their perception of the value of these schemes to their patients and factors that influence their use of these schemes. The purpose of adding to the evidence base regarding the use of such schemes in practice is to contribute to the design of initiatives which may address barriers to GPs’ promotion of physical activity, use of community based exercise referral schemes and levels of physical activity within the population, with increased likelihood of health benefits for patients. Background: A review of the literature suggests that GPs are reluctant to refer patients to exercise referral schemes, with a systematic review and meta-analysis raising uncertainties regarding their effectiveness or whether they are an effective use of resources (BMJ, 2011). Previous work found that a small minority of GPs were responsible for the vast majority of referrals with more referrals occurring in deprived areas. Another systematic review called for well-conducted qualitative studies to explore in more depth the barriers to exercise referral schemes (BJGP, 2007). Plan of Investigation: A mixed method approach shall first review and analyse data regarding GPs’ referrals to exercise referral schemes in Northern Ireland. Following this it is proposed to select a purposeful sample of GPs across Northern Ireland, based on differences in location, deprivation score of their practice locality, and rates of referral to exercise schemes. Within each practice thus selected individual general practitioners will be purposefully identified, based on information about their interest in readiness to refer, to include individuals with a range of referral practices. Various demographic details will be obtained from participants, including age, sex and a measure of their own levels of physical activity. Recruitment/Data collection: The individual GPs identified will be sent an invitation letter and information leaflet regarding the study. A topic guide for the interviews will be developed so that a semi-structured format will be followed. Field notes will be made, with participants’ consent and interviews will be recorded and transcribed for analysis. Sample size: It is anticipated that 20 GPs will be interviewed but recruitment will continue until data saturation is achieved. Analysis: A thematic framework analysis will be used to identify influences on GPs’ referrals to exercise schemes. Expected outcomes: This knowledge could bring about local protocol revision to overcome any barriers detected in relation to referring to these schemes, as a result increasing numbers of referrals from GPs. By facilitating better use of these schemes this may contribute to increase levels of physical activity within the population as a whole. It is planned to present the findings for publication in a peer-reviewed journal and to present them at local and national conferences.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES;7.3 MANAGEMENT AND DECISION MAKING
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL