The Active Herts community physical activity programme

The results from two parallel pieces of research informed the design, implementation, and evaluation of a large-scale physical activity programme across four of the most deprived areas of Hertfordshire. Active Herts targeted inactive adults with risk factors for CVD and/or mild to moderate mental health issues.

The first study was a systematic review, which identified the most effective behaviour change techniques to target inactive adults in physical activity interventions. The second study was an analysis of the COM-B theoretical framework for physical activity and sedentary behaviour. The findings from the first study provided evidence-informed techniques that were used with clients to encourage them to be more active. Findings from the second study identified key outcomes for the performance of physical activity.

In two areas, Active Herts programme users received a behaviour change technique booklet, regular consultations, a booster phone call (two weeks after initial consultation), motivational text messages, and signposting to 12 weeks of exercise classes (standard delivery). In another two areas, programme users also received 12 weeks of free tailored exercise classes, with optional exercise ‘buddies’ available (enhanced group).

A mixed methods evaluation looked at the practical effectiveness of the programme and a evaluation of the views of multiple stakeholders. The qualitative work highlighted adaptations to the design of promotional material, programme delivery content, and the addition of a participant community event. This enabled changes in response to the local context, as well as improvements in the programme to be captured in a timely manner, allowing the delivery to be responsive and the evaluation flexible.

The quantitative evaluation showed that attending Active Herts was associated with increased physical activity, sporting minutes, reduced sitting time, increased mental wellbeing, and improved perceptions of health. Increases in physical activity represented large clinically meaningful changes over the entire life of the programme, with approximately 1200 METs representing a change of 150 minutes of vigorous intensity, 300 minutes of moderate intensity, or over 350 of walking minutes per week. A clinically significant reduction in sitting was also seen of over one hour per day. Programme users also perceived their health to have improved significantly throughout the 12 month programme.