Data from the Health Survey for England showed that obesity reached epidemic proportions, affecting 29% of men and 32% of women in 2006. Obesity is a growing epidemic which instigates detrimental health risks associated with diabetes, coronary heart disease (CHD), coronary artery disease (CAD), musculo-skeletal problems, hypertension and many other conditions (Demura, 2007), (Mathieu et al, 2008), (Ogden, Carroll, Flegal, 2003), and (Trakas, Lawrece, Shear, 1999). Although these conditions may be largely due to genetics, metabolic factors or cultural factors, it is also widely accepted that environmental, social and behavioural factors are also pivotal in the role of sedentary behaviour and obesity (Curry et al, 2008).
As a result of the growing epidemic, action has been implemented via physical activity referral schemes (PARS) whereby GP’s refer their clients to health advisors and exercise practitioners. Armstrong et al (2006) explains that exercise prescription is devised to improve physical fitness, promote health and ensure safety during exercise.
Justification of exercise referral schemes as part of the public health strategy.
The government have introduced exercise referral schemes with the intention to increase physical activity and are prescribed in order to treat the cause of obesity and reduce/eliminate the health risks associated with sedentary lifestyles (Department of Health, 2001). They are becoming increasingly popular and prescribed by the NHS as they focus on lifestyle modifications rather than medication which merely treat the effects and symptoms of a certain condition.
Gidlow et al (1995) state that over the last decade in Britain, the number of prescribed PARS has increased from around 200 in 1994 to more than 800 in 1995 and are estimated to be incorporated into 89% of primary care trusts (Department of Health, 2004).
The Eastern Health and Social Services (EHSSB) initiated a physical activity referral scheme called Healthwise funded by the ‘Big Lottery’. The overall aim of Healthwise is to introduce clients who were referred via a healthcare professional (GP or registered nurse etc) due to factors such as being overweight/obese, to a regular physical activity regime in a warm, friendly, comfortable and safe environment. Their PARS is twelve weeks in duration where they encourage and motivate participants to adopt a positive attitude towards a more active lifestyle (EHSSB, No date).
However, the clients are permitted unlimited access to the leisure centre of their choice free of charge, with the ultimate goal of encouraging long term regular and independent participation in physical activity. This strategy can be criticised due to the free access of facilities. This is not a realistic situation and once the scheme terminates at twelve weeks, it is unclear as to whether the clients would be equally motivated to exercise independently, with the lack of support and added costs.
On the contrary, Wormald (2006) and Hillsdon et al (2005) state that the schemes are beneficial if the client has the will power and adherence to continue the regime independently which helps to increase their physical activity levels as well as improving their overall health and well being.