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Interpreting population reach of a large, successful physical activity trial delivered through primary care.

Kerry, SM; Morgan, KE; Limb, E; Cook, DG; Furness, C; Carey, I; DeWilde, S; Victor, CR; Iliffe, S; Whincup, P; et al. Kerry, SM; Morgan, KE; Limb, E; Cook, DG; Furness, C; Carey, I; DeWilde, S; Victor, CR; Iliffe, S; Whincup, P; Ussher, M; Ekelund, U; Fox-Rushby, J; Ibison, J; Harris, T (2018) Interpreting population reach of a large, successful physical activity trial delivered through primary care. BMC Public Health, 18 (1). p. 170. ISSN 1471-2458 https://doi.org/10.1186/s12889-018-5034-4
SGUL Authors: Carey, Iain Miller De Wilde, Stephen Harris, Teresa Jane Ussher, Michael Henry Whincup, Peter Hynes

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Abstract

BACKGROUND: Failure to include socio-economically deprived or ethnic minority groups in physical activity (PA) trials may limit representativeness and could lead to implementation of interventions that then increase health inequalities. Randomised intervention trials often have low recruitment rates and rarely assess recruitment bias. A previous trial by the same team using similar methods recruited 30% of the eligible population but was in an affluent setting with few non-white residents and was limited to those over 60 years of age. METHODS: PACE-UP is a large, effective, population-based walking trial in inactive 45-75 year-olds that recruited through seven London general practices. Anonymised practice demographic data were available for all those invited, enabling investigation of inequalities in trial recruitment. Non-participants were invited to complete a questionnaire. RESULTS: From 10,927 postal invitations, 1150 (10.5%) completed baseline assessment. Participation rate ratios (95% CI), adjusted for age and gender as appropriate, were lower in men 0.59 (0.52, 0.67) than women, in those under 55 compared with those ≥65, 0.60 (0.51, 0.71), in the most deprived quintile compared with the least deprived 0.52 (0.39, 0.70) and in Asian individuals compared with whites 0.62 (0.50, 0.76). Black individuals were equally likely to participate as white individuals. Participation was also associated with having a co-morbidity or some degree of health limitation. The most common reasons for non-participation were considering themselves as being too active or lack of time. CONCLUSIONS: Conducting the trial in this diverse setting reduced overall response, with lower response in socio-economically deprived and Asian sub-groups. Trials with greater reach are likely to be more expensive in terms of recruitment and gains in generalizability need to be balanced with greater costs. Differential uptake of successful trial interventions may increase inequalities in PA levels and should be monitored. TRIAL REGISTRATION: ISRCTN.com ISRCTN98538934 . Registered 2nd March 2012.

Item Type: Article
Additional Information: © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Non-participation, Physical activity, Primary care, Randomised trials, Recruitment, Public Health, 1117 Public Health And Health Services
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: BMC Public Health
ISSN: 1471-2458
Language: eng
Dates:
DateEvent
23 January 2018Published
4 January 2018Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
HTA 10/32/02Health Technology Assessment programmehttp://dx.doi.org/10.13039/501100000664
MET-12-16Research Trainees Coordinating Centrehttp://dx.doi.org/10.13039/501100000659
PubMed ID: 29361929
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/109529
Publisher's version: https://doi.org/10.1186/s12889-018-5034-4

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