Changes in self-determination during an exercise referral scheme

Although ERSs are increasing in popularity, it is difficult to draw conclusions about their effectiveness, largely due to a lack of adherence amongst patients, according to self-determination theory.

Abstract

Exercise referral schemes (ERSs) are now a common feature of UK primary health care. These schemes involve the referral of patients with specific health concerns (e.g. obesity, high blood pressure and mild anxiety/depression) to a local leisure centre by a health professional, and induction into a 10e12-week structured exercise programme at a reduced fee. Although ERSs are increasing in popularity, it is difficult to draw conclusions about their effectiveness, largely due to a lack of adherence amongst patients. For example, Dugdill et al. reported that of all patients referred to an ERS, 27% never made contact with the scheme. Of those who did make contact, only 34e46% adhered for the full length of the intervention. Adherence to exercise programmes depends on the motives for which exercise is undertaken. Extrinsic motives, such as compliance with external pressures (e.g. from health professionals), have been found to produce lower levels of adherence compared with those exercising for intrinsic reasons, such as feeling good and enjoyment. According to self-determination theory