Open Access Study protocol

Evaluation of a standard provision versus an autonomy promotive exercise referral programme: rationale and study design

Kate Jolly1, Joan L Duda2*, Amanda Daley1, Frank F Eves2, Nanette Mutrie3, Nikos Ntoumanis2, Peter C Rouse2, Rekha Lodhia2 and Geoffrey C Williams4

Author Affiliations

1 School of Health & Population Sciences, University of Birmingham, Birmingham B15 2TT, UK

2 School of Sport and Exercise Sciences, University of Birmingham, Birmingham B15 2TT, UK

3 Department of Sport, Culture and the Arts, Strathclyde University, Glasgow G13 1PP, UK

4 Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, New York 14627, USA

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BMC Public Health 2009, 9:176  doi:10.1186/1471-2458-9-176

Published: 8 June 2009



The National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT)-based exercise referral consultation.


Design: An exploratory cluster randomised controlled trial comparing standard provision exercise on prescription with a Self Determination Theory-based (SDT) exercise on prescription intervention.

Participants: 347 people referred to the Birmingham Exercise on Prescription scheme between November 2007 and July 2008. The 13 exercise on prescription sites in Birmingham were randomised to current practice (n = 7) or to the SDT-based intervention (n = 6).

Outcomes measured at 3 and 6-months: Minutes of moderate or vigorous physical activity per week assessed using the 7-day Physical Activity Recall; physical health: blood pressure and weight; health status measured using the Dartmouth CO-OP charts; anxiety and depression measured by the Hospital Anxiety and Depression Scale and vitality measured by the subjective vitality score; motivation and processes of change: perceptions of autonomy support from the advisor, satisfaction of the needs for competence, autonomy, and relatedness via physical activity, and motivational regulations for exercise.


This trial will determine whether an exercise referral programme based on Self Determination Theory increases physical activity and other health outcomes compared to a standard programme and will test the underlying SDT-based process model (perceived autonomy support, need satisfaction, motivation regulations, outcomes) via structural equation modelling.

Trial registration

The trial is registered as Current Controlled trials ISRCTN07682833.