Can community-based social marketing increase recruitment and adherence of a low-income group into organised physical activity?

Background Better health is strongly associated with higher social position. The poorest in society suffer the shortest life expectancy and are disproportionately affected by chronic illness and disability. This group participates less in the physical activity that could benefit their health and are less likely to engage with physical activity interventions. Social marketing has shown promise as a means of improving engagement with health programmes, however its effectiveness at increasing physical activity levels has not been fully tested. This study aimed to test whether social marketing could be an effective approach to increasing recruitment and adherence to organised physical activity in a disadvantaged neighbourhood. Method This study took a mixed methods approach. The formative research used a combination of quantitative and qualitative research methods to assess provision and attendance at physical activity sessions and to research motivations, barriers and enablers for participation in physical activity. Mixed methods were also used to assess the effectiveness ofthe social marketing intervention and to evaluate the intervention process. Results The formative research found that many participants in activity sessions in the study area were not from that area; word of mouth was the most influential form of promotion; and adherence rates were higher amongst older adults. Practical barriers to physical activity were cost, access to childcare, lack of time and low awareness. In addition, a perception of a lack of social support, and low perceived confidence and competence was widespread, particularly amongst women. Key enablers to being active were high levels of social interaction, interest and enjoyment. Using a grounded approach, Self Determination Theory was found to be the most appropriate theory to provide structure to the social marketing intervention. The intervention showed that social marketing is an effective approach to recruiting low income participants into exercise sessions, maintaining excellent levels of attendance and reasonable levels of adherence. Conclusions This thesis indicates that social marketing is an effective approach to increasing the recruitment and adherence of a low income group into organised physical activity. However clearer definitions of recruitment and adherence are required to enable a clearer comparison with other approaches. It is important that social marketing campaigns are well designed and implemented and that promotional or communications campaigns are not wrongly labelled as social marketing. Overall this study suggests that providing a variety of activities, incorporating some dance based sessions, and providing high levels offun, enjoyment and socialising appear to be key elements to successful recruitment and adherence. Low session cost and a high profile promotional campaign substantially impact campaign success and have implications for how organised physical activity in low income neighbourhoods is funded.EThOS - Electronic Theses Online ServiceGBUnited Kingdo