NIHR DC Discover

Published abstract

The impact of free access to leisure facilities and community outreach on inequalities in physical activity: a quasiexperimental study

Published on 12 January 2018

J Higgerson1 E Halliday, A Ortiz-Nunez, R Brown, B Barr

Journal of Epidemiology & Community Health , 2018

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Background There are large inequalities in levels of physical activity in the UK and this is an important determinant of health inequalities. Little is known about the effectiveness of community-wide interventions to increase physical activity and whether effects differ by socioeconomic group. Methods We conducted Interrupted Time Series and Difference-in-Differences analyses using local administrative data and a large national survey to investigate the impact of an intervention providing universal free access to leisure facilities alongside outreach and marketing activities in a deprived local authority area in the North West of England. Outcomes included attendances at swimming and gym sessions, and self-reported participation in gym and swim activity and any physical activity. Results The intervention was associated with a 64% increase in attendances at swimming and gym sessions (RR: 1.64 95%CI: 1.43 to 1.89, p<0.001) an additional 3.9% of the population participating in at least 30 minutes of moderate intensity gym or swim sessions during the previous 4 weeks (95%CI 3.6 to 4.1) and an additional 1.9% of the population participating in any sport or active recreation of at least moderate intensity for at least 30 minutes on at least 12 days out of the last 4 weeks (95%CI 1.7 to 2.1). The effect on gym and swim activity and overall levels of participation in physical activity was significantly greater for the more disadvantaged socioeconomic group. Conclusions The study suggests that removing user charges from leisure facilities in combination with outreach and marketing activities can increase overall population levels of physical activity whilst reducing inequalities.