An evaluation of a community-based intervention in England aiming to reduce inequalities in exercise participation.

Introduction: Exercise referral schemes are a common intervention that seek to address physical inactivity. There is limited evidence on whether they can address the inequalities in inactivity associated with income, age, and gender. A novel intervention that sought to address barriers to the uptake of physical activity schemes including access, cost, and specific health and social needs of participants was evaluated in a mixed methods study. Methods: Serial qualitative interviews with participants were conducted across three time points over the six-month intervention and the routine outcome data collected by the delivery partner were statistically analysed after stratification for referral route, demographic and socioeconomic status and engagement. Data from non-participants in the intervention from the targeted community were collected through street intercept surveys. A descriptive cost analysis was undertaken to understand the cost of delivery. Results and discussion: The study found small improvements in health outcomes and engagement. The novel features of the intervention that aimed to address inequalities in the uptake of physical activity-personalised programme, extended time offer, free and subsidised offer, a dedicated health coach-all succeeded in acting as enablers to uptake although very few individuals met the recommended frequency for attendance.