Participant experiences of an exercise referral scheme in England: The importance of measuring social value

Background: Exercise referral schemes are widely perceived to generate health and wellbeing benefits for individuals with, or at risk of, health problems. Understanding the social value of exercise referral schemes – in terms of factors that influence service user engagement and experiences of attending an exercise referral scheme – is important to foster positive change and improve decision-making. Methods: A social value approach was adopted to qualitatively explore experiences of engaging with an exercise referral scheme in one local authority in the North-West of England. Thirty-five service users (men = 21, women = 14) took part in focus groups ( n = 5), paired interviews ( n = 1) or individual interviews ( n = 5). Data were thematically analysed to explore the perceived benefits (i.e. outcomes) of the exercise referral scheme when compared to the costs (i.e. barriers, inconveniences), and the extent to which participants attribute the benefits to the exercise referral scheme. Results: Findings were explored through two key social value areas: outcomes – personal-emotional, physical and social outcomes (both positive and negative, intended and unintended); and attribution and maintenance of change. Participants reported improved physical, mental and social health and were motivated by a sense of community spirit and camaraderie. They expressed the desire to continue attending exercise referral scheme sessions and maintain the changes experienced. Conclusion: The benefits of attending the exercise referral scheme were experienced beyond physical health to wellbeing on a personal-emotional and social level. Programmes should explore the inclusion of social value measurement in the longer term to provide services that are responsive to change, meet the needs of their communities and have tangible, measurable impacts.