abstract: 'Exercise referral schemes (ERS) are internationally recognised, yet

  little attention has been paid to discrete referral groups or the

  influence of wider social determinants of health. The primary

  quantitative element of this mixed methods study used a mixed effects

  linear model to examine associations of sociodemographic predictors,

  obesity class and profession of referrer on weight and physical activity

  (PA) variables for weight-related referrals (n= 3624) to an established

  24-week ERS. Chained equations modelling imputed missing data. The

  embedded qualitative element (n= 7) used individual semi-structured

  interviews to explore participant weight-related expectations and

  experiences. Age, gender and profession of referrer influenced weight

  loss. PA increased and was influenced by age and gender. The weight gap

  between the most and least obese narrowed over time but the PA gap

  between most and least widened. Age, employment and obesity class were

  most predictive of missing data but would unlikely alter overall

  conclusions. Qualitative themes were weight-loss support, personal

  circumstances and strategies, and weight expectations versus wellbeing

  rewards. This ERS worked, did not widen existing obesity inequalities,

  but demonstrated evidence of PA inequalities for those living with

  deprivation. To improve equity of experience, we recommend further

  stakeholder dialogue around referral experience and ongoing support

  needs.'
affiliation: 'Dodd-Reynolds, CJ (Corresponding Author), Univ Durham, Dept Sport \&
  Exercise Sci, Durham DH1 3HN, England.

  Dodd-Reynolds, CJ (Corresponding Author), Univ Durham, Wolfson Res Inst Hlth \&
  Wellbeing, Phys Act Special Interest Grp, Durham DH1 3HN, England.

  Dodd-Reynolds, CJ (Corresponding Author), Univ Durham, Durham Res Methods Ctr, Durham
  DH1 3HN, England.

  Dodd-Reynolds, Caroline J., Univ Durham, Dept Sport \& Exercise Sci, Durham DH1
  3HN, England.

  Dodd-Reynolds, Caroline J.; Kasim, Adetayo; Akhter, Nasima, Univ Durham, Wolfson
  Res Inst Hlth \& Wellbeing, Phys Act Special Interest Grp, Durham DH1 3HN, England.

  Dodd-Reynolds, Caroline J.; Vallis, Dimitris; Kasim, Adetayo, Univ Durham, Durham
  Res Methods Ctr, Durham DH1 3HN, England.

  Kasim, Adetayo; Akhter, Nasima, Univ Durham, Dept Anthropol, Durham DH1 3HN, England.

  Hanson, Coral L., Edinburgh Napier Univ, Sch Hlth \& Social Care, Edinburgh EH11
  4BN, Midlothian, Scotland.'
article-number: '5297'
author: Dodd-Reynolds, Caroline J. and Vallis, Dimitris and Kasim, Adetayo and Akhter,
  Nasima and Hanson, Coral L.
author-email: 'caroline.dodd-reynolds@durham.ac.uk

  dimitris.vallis@durham.ac.uk

  a.s.kasim@durham.ac.uk

  nasima.akhter@durham.ac.uk

  c.hanson@napier.ac.uk'
author_list:
- family: Dodd-Reynolds
  given: Caroline J.
- family: Vallis
  given: Dimitris
- family: Kasim
  given: Adetayo
- family: Akhter
  given: Nasima
- family: Hanson
  given: Coral L.
da: '2023-09-28'
doi: 10.3390/ijerph17155297
eissn: 1660-4601
files: []
journal: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
keywords: 'exercise referral; obesity; physical activity; inequalities;

  sociodemographic'
keywords-plus: 'PHYSICAL-ACTIVITY; PRIMARY-CARE; SOCIOECONOMIC POSITION;

  COST-EFFECTIVENESS; PUBLIC-HEALTH; INTERVENTIONS; OBESITY; INEQUALITIES;

  VALIDATION; PREDICTORS'
language: English
month: AUG
number: '15'
number-of-cited-references: '63'
orcid-numbers: 'Hanson, Coral L/0000-0003-1602-1968

  Akhter, Nasima/0000-0002-5424-1593

  Kasim, Adetayo Safiriyu/0000-0002-0411-3059

  Dodd-Reynolds, Caroline/0000-0003-0670-8264'
papis_id: 3d0784520a11afb58c89134af7158c87
ref: Doddreynolds2020northumberlandexerci
researcherid-numbers: 'Hanson, Coral L/K-4215-2017

  Akhter, Nasima/AAL-3670-2020

  '
times-cited: '4'
title: 'The Northumberland Exercise Referral Scheme as a Universal Community Weight
  Management Programme: A Mixed Methods Exploration of Outcomes, Expectations and
  Experiences across a Social Gradient'
type: article
unique-id: WOS:000559216300001
usage-count-last-180-days: '0'
usage-count-since-2013: '1'
volume: '17'
web-of-science-categories: Environmental Sciences; Public, Environmental \& Occupational
  Health
year: '2020'