Reducing inequalities in exercise participation: Evaluation of the novel ‘Bracknell Forest Health and Well-Being Locality Service’ (BFHWBS)

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. Three further service users were recruited to create a PPIE Advisory Panel. The panel has supported the evaluation in a variety of ways: 

1. Reviewing and providing feedback on participant information sheets to ensure content and language is appropriate. 

2. Discussing the content and wording of surveys and interviews. 

3. Considering and discussing recruitment strategies. 

4. Discussing emergent findings. 

5. Reviewing and feeding back on lay summaries to ensure content and language is appropriate. 

6. Assisting with the development of the dissemination plan engaging with dissemination. 

Lay summary of research

What is this evaluation about? 

The public health department at Bracknell Forest Council 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 can help to improve understanding of how to set up a service that can help people to become, and stay, physically active and to reduce inequalities in the take up of such a service. 

How will it be carried out? 

We used a combination of methods to evaluate the service. The evaluation activities were organised into four related work packages. 

1. As part of work package one, we organised workshops with local professionals to map the factors that enable physical activity in the local area.  This helped us to understand the existing local system for physical activity.  

2. In work package two we carried out interviews with local people who have been referred (or self-referred) to the service. We interviewed people who attended the service but also those who could not attend or who attended at first and then stopped.  We also analysed the data collected by Everyone Active.  

3. In work package three, we carried 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. 

4. In work package four in collaboration with the service providers we conducted a descriptive cost analysis of the program delivery. The exact nature of these costs were identified through a workshopping process and provided helpful contextual information for the local service providers and commissioners. 

What will we do with the results? 

Learning from this evaluation can help to provide recommendations for the service and best practice guidance for councils hoping to use this service model.  We have shared 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 are also planning, with our partners, to disseminate academic and briefing papers for the public health sector.