This section covers NIHR funded research into efforts to increase physical activity through public sports and leisure services. Facilities range from multi-function leisure centres and sports clubs, to swimming pools and outdoor activities. They are owned by local councils, and often operated by other organisations or community trusts. NIHR research also looked at community programmes, such as exercise classes and to encourage walking.

What’s the context?

• Many people in the UK are not meeting physical activity guidelines, particularly in deprived areas. Local authorities are expected to promote physical activity in their local communities as part of obesity prevention (NICE).
• The more deprived an area is, the more dependent people are on public sports and leisure provision (Local Government Association).
• The COVID-19 pandemic has disrupted people’s ability to exercise, particularly children and young people (Sport England). It disrupted public sport and leisure services, which lost income during long periods of closure (Local Government Association). The future of leisure centres needs to be secured to tackle the growing obesity crisis (District Councils’ Network).
• There have been calls to unlock the potential of fitness and leisure facilities to serve more people through social prescribing (UKactive).

What does NIHR research tell us?

Free access to leisure facilities can help people to be more physically active

Free access to leisure facilities can increase participation in swim and gym activities,(1,2) by removing financial barriers and providing an incentive to use facilities.(3) However, the evidence on the benefits to those most in need is mixed. Some research has found that removing charges increases use among more disadvantaged groups.(1,4) For example, free holiday swims for children have been shown to increase the numbers of swimmers in deprived areas, and could reduce inequalities in physical activity.(4) But other research found that it may not be sufficient to encourage inactive adults and those living in disadvantaged neighbourhoods to take up regular exercise.(2)

Walking programmes can be a cost-effective way to increase physical activity

A programme to promote walking in adults (aged 45 to 75) involved a pedometer, walking plan, tips on how to change behaviour, and support via nurse consultations (for one group). It increased step count and weekly activity levels in both groups, and these changes were sustained at 3 years. The group without nurse support offered best value for money.(5)

There is little evidence that community programmes lead to sustained physical activity

Overall, research on the effectiveness of community exercise programmes is mixed – studies have not demonstrated an effect beyond 12 months. One study gave plans to encourage walking to people aged 65+, along with weekly home or class-based exercise. At 12 months, classes held in the community centre were more successful in increasing physical activity than home exercise classes.(8) Another study offered a range of physical activities to people of all ages living in rural villages. This led to a slight increase in minutes of moderate-to-vigorous intensity activity per week but did not increase the likelihood of meeting physical activity guidelines.(9) In a middle-aged population (40 to 64 years) from a deprived area, motivational interviews to sustain increased physical activity (by telephone or face to face) did not influence activity levels. The ‘booster’ intervention was unlikely to be clinically- or cost-effective; further research is needed on how to sustain physical activity.(10)

Factors that can help or hinder community programmes have been explored among adults in mid-to-late life. Poor awareness of community-based programmes is a barrier to people over 55.(6) People aged 40 to 64 were encouraged to attend by: enjoyment, social support, and tailored programmes. Addressing affordability helped people living in deprived areas.(6,7)

Useful resources

• The Association for Public Service Excellence, the Local Government Association and Chief Cultural and Leisure Officers Association have proposed a rethink of what local communities will need from leisure facilities and services in the future. New, more efficient and impactful solutions need to be designed to help communities to be active and stay healthier for longer. They consulted over 250 local councils and the report contains examples of initiatives by councils and leisure services.
• Sport England has been testing approaches to using sport and physical activity to tackle obesity. It has shared a resource to approaches, models and tools that can be adapted to local needs.
• NICE guidance advises that local authorities should have senior physical activity champions to raise the profile of physical activity and to develop local initiatives with members of the community.

NIHR research in progress

Several studies are looking at physical activity among older adults. In Northern Ireland, a peer-led walking programme for inactive adults (60+) in disadvantaged areas is being investigated.(11) Another peer-led programme is for adults at risk of mobility disability (65+), in England and Wales.(12) A third study is evaluating weekly exercise classes in preventing mobility-related disability in retired people (65+).(13)
How effective is ‘snacktivity’ – an activity snack of 2-5-minutes (such as walking while on the phone)? (14)

1. Higgerson J, Halliday E, Ortiz-Nunez A, Brown R, Barr B. Impact of free access to leisure facilities and community outreach on inequalities in physical activity: a quasi-experimental study. J Epidemiol Community Health. 2018 Mar;72(3):252–8.
2. Candio P, Meads D, Hill AJ, Bojke L. Does providing everyone with free-of-charge organised exercise opportunities work in public health? Health Policy. 2022 Feb 1;126(2):129–42.
3. Ward F, Halliday EC, Barr B, Higgerson J, Holt V. Leisure centre entrance charges and physical activity participation in England. Health Promot Int. 2019 Jun 1;34(3):379–88.
4. Higgerson J, Halliday E, Ortiz-Nunez A, Barr B. The impact of free access to swimming pools on children’s participation in swimming. A comparative regression discontinuity study. J Public Health Oxf Engl. 2019 Jun 1;41(2):214–21.
5. Harris T, Kerry S, Victor C, Iliffe S, Ussher M, Fox-Rushby J, et al. A pedometer-based walking intervention in 45- to 75-year-olds, with and without practice nurse support: the PACE-UP three-arm cluster RCT. Health Technol Assess. 2018 Jul 2;22(37):1–274.
6. Olanrewaju O, Kelly S, Cowan A, Brayne C, Lafortune L. Physical Activity in Community Dwelling Older People: A Systematic Review of Reviews of Interventions and Context. PLOS ONE. 2016 Dec 20;11(12):e0168614.
7. Kelly S, Martin S, Kuhn I, Cowan A, Brayne C, Lafortune L. Barriers and Facilitators to the Uptake and Maintenance of Healthy Behaviours by People at Mid-Life: A Rapid Systematic Review. PLOS ONE. 2016 Jan 27;11(1):e0145074.
8. Iliffe S, Kendrick D, Morris R, Masud T, Gage H, Skelton D, et al. Multi-centre cluster randomised trial comparing a community group exercise programme with home based exercise with usual care for people aged 65 and over in primary care. Health Technol Assess. 2014 Aug 7;18(49):1–106.
9. Solomon E, Rees T, Ukoumunne OC, Metcalf B, Hillsdon M. The Devon Active Villages Evaluation (DAVE) trial of a community-level physical activity intervention in rural south-west England: a stepped wedge cluster randomised controlled trial. Int J Behav Nutr Phys Act. 2014 Jul 18;11(1):94.
10. Goyder E, Hind D, Breckon J, Dimairo M, Minton J, Everson-Hock E, et al. A randomised controlled trial and cost-effectiveness evaluation of ‘booster’ interventions to sustain increases in physical activity in middle-aged adults in deprived urban neighbourhoods. Health Technol Assess. 2014 Feb 27;18(13).
11. Tully MA. Effectiveness and cost-effectiveness of a peer-led walking programme to increase physical activity in inactive older adults: Walk With Me Study NIHR131550. NIHR Funding and Awards Search Website. [cited 2022 Feb 4].
12. Stathi A. A multi-centre randomised controlled trial of a peer-volunteer led active ageing programme to prevent decline in physical function in older people at risk of mobility disability. The ACE (Active, Connected, Engaged) study. NIHR130156. NIHR Funding and Awards Search Website. [cited 2022 Feb 4].
13. Stathi A. A randomised controlled trial and economic evaluation of a community-based physical activity intervention to prevent mobility-related disability for retired older people. The REACT (REtirement in ACTion) study. PHR-13/164/51. [cited 2022 Feb 4].
14. Daley A. ‘Snacktivity’ to promote physical activity and reduce future risk of disease in the population. NIHR Funding and Awards Search Website. [cited 2022 Feb 24].