Exploration into the equity of the impact of Exercise Referral Scheme (ERS) among different ethnic populations in the UK

While overall health and mental benefits of Exercise Referral Scheme (ERS) have been assessed, this cross-sectional study explored how participant diversity may influence scheme outcomes, focusing on different ethnic groups, to inform future interventions.

Data from 23,782 prescribed participants across 14 ERSs were extracted from the National Referral Database. Relevant variables of participants including age, ethnicity, PA levels, and mental wellbeing were used in the analyses. Inferential statistics were conducted, with age as a covariate, to determine differences in baseline and change values of PA levels and mental wellbeing among participants in various ethnic groups.

Upon ERS uptake, various ethnic groups had difference baseline PA level (F(4, 16,670) = 17.96, p < 0.001) and mental wellbeing (F(4, 3418) = 51.83, p < 0.001). White and Asian groups had the highest and lowest mean PA levels (MET·minutes·week⁻¹), respectively. For mental wellbeing, Black participants had the highest mean score (pts) with the lowest score found in Asian group. However, on completing ERS, the increased magnitudes (relative to their baseline) of these two variables ((F(4, 6484) = 1.511, p = 0.196) for PA level and (F(4, 1396) = 1.324, p = 0.259) for mental wellbeing) were not statistically different across the five ethnic groups. Interestingly, higher dropout rates were observed among highly active, younger, and Mixed ethnic participants.

Different ethnic backgrounds showed varying baseline PA levels and mental wellbeing, albeit racial differences appeared to have less impact on benefits from the referrals. However, participant diversity might be linked to different scheme adherence, warranting further qualitative studies to identify potential support mechanisms.