Reducing inequalities in exercise participation: Evaluation of the novel ‘Bracknell Forest Health and Well-Being Locality Service’ (BFHWBS)
Evaluation in progress. Expected completion date January 2024
What does the research mean for Local Authorities?
This mixed-methods evaluation will explore the effectiveness of a novel initiative for tackling physical inactivity in Bracknell Forest. Using a whole systems approach, the evaluation will identify key structures and factors influencing physical activity in the local area and explore their priorities and relationships. This will help to plan and implement city-wide action to successfully promote physical activity to diverse populations. The findings from interviews with service stakeholders, service users and local people will inform how best to design and implement services that are feasible, cost effective and acceptable to people with long term conditions and those least likely to be active. Understanding of the benefit from adopting a different approach to thinking in public health can help local authorities to prioritise where to intervene in the local system, leverage the greatest impact, align effort and drive change.
What does the evaluation research mean for the Public?
To reduce sedentary behaviours, it is important to know how best to motivate, recruit and retain diverse people into local physical activity services. This evaluation will help inform the local public whether the Bracknell Forest Health and Well-being Locality Service has successfully reached out to the most inactive and at-risk individuals by diversifying the entry routes into an exercise promotion service and providing personalised needs assessment and support. The perspectives of all people involved in the evaluation will help to inform the design of future support that will achieve higher uptake from a wider population and facilitate reduced inequalities in exercise participation and improved overall health status of the local population.
How are the public involved in the evaluation?
Before starting the evaluation we ran three workshops with our local authority partners. Two public involvement representatives attended the workshops and helped us to develop our evaluation plan. We have since appointed three further service users to create a PPIE Advisory Panel. The panel will support the evaluation in a variety of ways:
- Reviewing and providing feedback on participant information sheets to ensure content and language is appropriate.
- Discussing the content and wording of surveys and interviews.
- Consider and discuss recruitment strategies.
- Discussing emergent findings.
- Review and feedback on lay summaries to ensure content and language is appropriate.
- Assist with the development of the dissemination plan and possibly engage with dissemination if available/willing.
Lay summary of research
What is this evaluation about?
The public health department at Bracknell Forest Council has founded the Bracknell Forest Health and Well-being Locality Service in September 2022. It is delivered by Everyone Active, a leading provider of leisure services. The service aims to encourage physical activity to improve health and quality of life for residents. It is different from traditional Exercise Referral Services because the service is free of charge for those from socially disadvantaged communities. People can also self-refer to the service or be referred by a social prescriber instead of having to be referred by a General Practitioner. The service employs Health and Well-Being coaches who create a tailored exercise programme based on the needs of the individual and who will signpost people to other community services, if helpful. The evaluation team will assess how the novel aspects of the service help reduce the inequalities in physical activity participation. We will investigate whether the structures and agents in the local system effectively support physical activity delivery.
What do we already know?
There are lots of well-known benefits to regular physical activity. However, globally and within the UK, there are still high levels of physical inactivity. Many studies have reported positive outcomes from Exercise Referral Services. However, clinical guidelines in 2014 recommended that such services should be provided only to individuals who have existing health conditions or risk factors and are inactive and not to those who are otherwise healthy. Community-based physical activity programmes that target and engage ‘at-risk’ groups such as those living in social deprivation can provide wider opportunities to become physically active. This can take place through self-referral and social prescription, regardless of health status.
What don’t we know?
Not enough is known about:
- The type of service that is acceptable to people with long-term conditions and those least likely to be active.
- What would encourage people to use the service.
- What makes it difficult for people to use the service.
- The best ways to recruit people and encourage them to continue using the service.
Why is an evaluation necessary?
Our evaluation will improve understanding of how to set up a service that can help people to become, and stay, physically active. We need to work out how to reduce inequalities in physical activity and make the wider system for physical activity more engaged and sustainable.
How will it be carried out?
We will use a combination of methods to evaluate the service. The evaluation activities will be organised into four related work packages.
- As part of work package one, we will organise workshops with local professionals to map the factors that enable physical activity in the local area. This will help us understand the existing local system for physical activity.
- In work package two we will carry out interviews with local people who have been referred (or self-referred) to the service. We will interview people who attended the service but also those who could not attend or who attended at first and then stopped. We will also analyse the data collected by Everyone Active.
- In work package three, we will carry out a street-survey with local residents who belong to the target groups but who have never used the service to gain a deeper understanding of their attitude towards physical activity for health and their views on the service.
- In work package four in collaboration with the service providers we will conduct a descriptive cost analysis of the program delivery. The exact nature of these costs will be identified through the workshopping process and will provide helpful contextual information for the local service providers and commissioners.
What will we do with the results?
What we learn from this evaluation will help us to provide recommendations for the service and best practice guidance for councils hoping to use this service model. We will share the evaluation findings with the Bracknell Forest Health and Well-being Locality Service, Everyone Active, and the public health department at Bracknell Forest Council. We will also, with our partners, disseminate academic and briefing papers for the public health sector.
Local Authority / Partner(s)
Public Health department at Bracknell Forest council
PHIRST South Bank Research Team
Prof Katya Mileva (PI), Prof. Susie Sykes, Prof. Jane Wills, Dr. Lisa Zaidell, Ms. Terassa Taylor-Kaveney, Dr. Charles Graham, Prof. Chris Flood