Randomised controlled trial of an augmented exercise referral scheme using web-based behavioural support for inactive adults with chronic health conditions: the e-coachER trial

Br J Sports Med. 2021 Apr;55(8):444-450. doi: 10.1136/bjsports-2020-103121. Epub 2020 Nov 27.

Abstract

Objective: To determine whether adding web-based support (e-coachER) to an exercise referral scheme (ERS) increases objectively assessed physical activity (PA).

Design: Multicentre trial with participants randomised to usual ERS alone (control) or usual ERS plus e-coachER (intervention).

Setting: Primary care and ERS in three UK sites from 2015 to 2018.

Participants: 450 inactive ERS referees with chronic health conditions.

Interventions: Participants received a pedometer, PA recording sheets and a user guide for the web-based support. e-coachER interactively encouraged the use of the ERS and other PA options.

Main outcome measures: Primary and key secondary outcomes were: objective moderate-to-vigorous PA (MVPA) minutes (in ≥10 min bouts and without bouts), respectively, after 12 months. Secondary outcomes were: other accelerometer-derived and self-reported PA measures, ERS attendance, EQ-5D-5L, Hospital Anxiety and Depression Scale and beliefs about PA. All outcomes were collected at baseline, 4 and 12 months. Primary analysis was an intention to treat comparison between intervention and control arms at 12-month follow-up.

Results: There was no significant effect of the intervention on weekly MVPA at 12 months between the groups recorded in ≥10 min bouts (mean difference 11.8 min of MVPA, 95% CI: -2.1 to 26.0; p=0.10) or without bouts (mean difference 13.7 min of MVPA, 95% CI: -26.8 to 54.2; p=0.51) for 232 participants with usable data. There was no difference in the primary or secondary PA outcomes at 4 or 12 months.

Conclusion: Augmenting ERS referrals with web-based behavioural support had only a weak, non-significant effect on MVPA.

Trial registration number: ISRCTN15644451.

Keywords: accelerometer; behaviour; chronic; physical activity; primary care.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Behavior Therapy
  • Chronic Disease / rehabilitation*
  • Exercise Therapy / methods*
  • Female
  • Health Behavior*
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Referral and Consultation
  • Sedentary Behavior
  • Social Support*
  • Young Adult