General Medicine · Medical Literature
Move Together Buckinghamshire: protocol for a pragmatic mixed-methods evaluation of a community physical activity programme for older adults with long-term conditions
Abstract
Introduction Physical inactivity is highly prevalent in older adults living in deprived communities, with many living with long-term health conditions. Community-based and tailored physical activity behaviour change programmes are needed to support increased physical activity in this population. This project aims to conduct a pragmatic pre-post mixed-methods evaluation of a community-based physical activity intervention (Move Together Buckinghamshire). Methods and analysis Move Together Buckinghamshire is a 3-year community-based physical activity programme for inactive adults aged over 50 years with at least one long-term health condition living in deprived areas of Buckinghamshire, England. Across the 12-week programme, users will receive: (i) one 45-minute in-person one-to-one consultation with a Physical Activity Referral Specialist (PARS), (ii) three check-in contacts with their allocated PARS taking place by email, phone or text and (iii) access to an online platform to identify and book physical activity opportunities in their local area. The programme’s recruitment target is 3000 service users over the 3-year programme. This pragmatic evaluation will assess the first 18 months of programme delivery using a mixed-methods design. A quantitative outcome evaluation will be conducted for secondary data routinely collected within the programme to assess the primary outcome of physical activity (using the single-item physical activity measure), and secondary outcomes of health-related quality of life, loneliness and confidence to engage in physical activity (assessed at baseline, during and at the end of the 12-week programme and at 6-month and 12-month follow-up). A qualitative process evaluation will use focus groups and interviews with service users and interviews with PARS staff delivering the programme and strategic decision-makers. An economic analysis will be undertaken to estimate the resources and costs required to design, set up and deliver the Mov
Clinical relevance
Physical inactivity disproportionately affects older adults with long-term conditions living in deprived communities, a population at high risk for multimorbidity, functional decline, loneliness, and reduced health-related quality of life. Existing evidence supports community-based physical activity referral schemes, yet robust real-world evaluations integrating quantitative outcomes, qualitative process data, and health economics remain scarce for this demographic. This protocol is clinically timely as healthcare systems increasingly seek scalable, cost-effective social prescribing solutions to reduce the burden of long-term conditions in underserved older populations.
Key findings
NOTE: This is a published protocol paper; no outcome data are yet available. Quantitative findings, effect sizes, confidence intervals, p-values, and NNT/NNH cannot be reported. The following represent key design parameters: 1. Target population: inactive adults aged ≥50 years with ≥1 long-term health condition residing in deprived areas of Buckinghamshire, England. 2. Programme structure: 12-week intervention comprising one 45-minute in-person consultation with a Physical Activity Referral Specialist (PARS), three follow-up check-in contacts (email/phone/text), and access to an online platform for local activity booking. 3. Recruitment target: 3,000 service users over the 3-year programme; the evaluation covers the first 18 months of delivery. 4. Primary outcome: physical activity level measured via the validated single-item physical activity measure, assessed at baseline, mid-programme, end of programme (12 weeks), and at 6- and 12-month follow-up. 5. Secondary outcomes include health-related quality of life, loneliness, and self-efficacy/confidence to engage in physical activity, assessed at the same time points. 6. A concurrent mixed-methods design integrates: (a) quantitative outcome evaluation using routinely collected programme data, (b) qualitative process evaluation via focus groups and interviews with service users, PARS staff, and strategic decision-makers, and (c) an economic analysis estimating resources and costs of programme design, setup, and delivery.
Practice implications
Clinicians and commissioners working with multimorbid older adults in deprived settings should monitor the forthcoming results of this evaluation, as it will provide real-world evidence on whether a low-intensity, PARS-delivered physical activity referral model (single consultation plus three remote check-ins) is sufficient to produce sustained behaviour change at 6 and 12 months. If effective, this model offers a scalable social prescribing template suitable for integration into primary care and social care pathways, particularly for patients who are inactive, socially isolated, and living with conditions such as cardiovascular disease, diabetes, or musculoskeletal disorders. The embedded economic analysis will be critical for informing commissioning decisions and resource allocation across health and local authority partners.