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Dr. Raisanen is is currently part of a select team evaluating the Welsh
National Exercise Referral Scheme.
Dr. Raisanen is responsible for aiding in the research design and methodology, managing the day-to-day operations of the evaluation, setting up and
managing a database for storing data, meeting with key partners regularly to ensure
the evaluation runs to plan, supervising assistants working on the project, analysing results, as
well as writing reports and journal articles.
Reports:
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DETAILS: (or as PDF)
Research Team
Professor
Laurence Moore, CISHE (Principal Invesigator)
Dr
Simon Murphy, CISHE (Senior Research Fellow)
Dr Larry Raisanen, CISHE (Research Associate)
Start date: May 2006
End date: April 2009
Funding: Moore L and Murphy,
S. Evaluation of National Exercise Referral Scheme. National Assembly
for Wales.
The Study
It is widely recognised that physical activity confers a number of health
benefits; prime among them is a reduced risk from chronic disease such
as coronary heart disease (CHD) and depression/anxiety. Summaries of
research highlight an almost 50% reduction in CHD related mortality
for more active individuals (DOH, 2004). Increased levels of physical
activity are associated with lowering diastolic and systolic blood pressure
and with lower risk of stroke. Physical activity is also positively
associated with the production of HDL cholesterol. Whilst reviews of
available of evidence have also concluded that exercise is positively
linked with mental health (Callahagan, 2003) and to be effective in
treating symptoms of depression (MERC, 2005).
Exercise referral schemes (ERS) have become increasingly
popular as a way of addressing CHD risk and mental health issues. In
the primary care context, it has been argued that there is both the
contact opportunity and the availability of credible sources of health
advice to influence health behaviours (Graham et al, 2005). However,
it has been stated that “there is no review level of evidence
of effectiveness of exercise referral schemes” (Hillsdon et al,
2004:9) and the majority of reported studies are US based with limited
applicability to the Welsh and UK context. In addition, recent NICE
guidance states that “practitioners, policy makers and commissioners
should only endorse exercise referral schemes…that are part of
a properly designed and controlled research study to determine effectiveness”
(2006).
It is against this background, that a review of the available evidence
and an examination of current policy and practice are being undertaken
in Wales . The development of national standards and protocol and the
rigorous evaluation of a major policy initiative represent an exciting
opportunity to add to a developing evidence base in public health improvement
and to contribute to the development of Health Challenge Wales. The
Welsh Assembly Government is seeking to invest over £4 million
over the next three years to support the evaluation and development
of exercise referral schemes in Wales . This investment seeks to determine
the effectiveness of exercise referral in improving health and increasing
physical activity levels, to look at health economic measures and support
existing schemes across Wales who may otherwise have to stop due to
current short term funding arrangements.
CISHE recently won the tender from the Welsh Assembly Government to
perform an independent evaluation of this national exercise referral
scheme (NERS). The evaluation is being conducted in collaboration with
the following partners:
- General Practices, North Wales Clinical School, Cardiff University,
- Centre for Economics and Policy in Health, Bangor University
- Sport, Health and Exercise Sciences, Bangor University
- Department of Exercise and Health Sciences, Bristol University
The aim of the project is to determine the effectiveness of the NERS
as it is rolled out in 13 implementation areas using a randomised control
trial design over the next two years. The provisional study design involves
a period of piloting outcome measures and developing protocols followed
by general practice recruitment in partnership with each area's exercise
co-ordinators. Participants (n = ~2400) will be randomised to either
a treatment or control group and will complete baseline, 6 month, and
12 month follow-up measures. A detailed process evaluation will also
be conducted throughout the trial.
The first six schemes should be up and running in May-June 2007. These
will be operating in Neath, Blaenau Gwent, Cardiff , Swansea , Bridgend
and Conwy. After this, a further seven areas look to join the national
exercise referral scheme by winter 2007 and the remaining LHBs by winter
2008.
CISHE is very pleased to be a contributing member to a project of such
national importance and we look forward to collaborating with all involved
parties to make this a success. For further information on the National
Exercise Referral Scheme, visit the Welsh
Assembly Government’s website
Contact
Dr Larry Raisanen: RaisanenL@cardiff.ac.uk
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