Using activity monitors to support physical activity changes: experiences from exercise referral schemes in Wales

Background The PACERS study is a pilot randomised controlled trial of the use of accelerometry-based activity monitors within the Welsh National Exercise Referral Scheme (NERS) to support longer-term maintenance of physical activity. The 16-week scheme has been running since 2007, a previous trial of the scheme demonstrated small but significant impacts on physical activity at 12-month follow-up. In general, exercise referral schemes have had mixed successes, often demonstrating only short-term effects on physical activity. Activity monitors may promote physical activity, and long-term maintenance of changes in physical activity, by facilitating goal setting and progress monitoring. Goal setting interventions show promising effects for increasing physical activity. Methods 20 intervention participants from the trial took part in a semi-structured interview shortly after receiving the activity monitor and 12-months later. NERS practitioners were also interviewed at the same time points (n = 12). Interviews were analysed using thematic analysis. Results Participants’ experiences of using the activity monitors suggest that existing IT access/literacy and support from NERS staff are key factors influencing their use. The majority of participants reported that the device helped them to be more aware of their physical activity levels and increased their motivation. Conclusions The findings enhance understanding of the processes of delivering motivational enhancement tools within exercise referral schemes and insights for refinements. Conclusions are dependent on integration of these results with quantitative data from the trial, which will inform a decision of whether to proceed to a full-scale trial of effectiveness. The results will be fed back directly to NERS staff and other stakeholders to inform future delivery of NERS and use of activity monitors within exercise referral schemes in general