Assessing the psychosocial factors associated with adherence to exercise referral schemes: A systematic review

Scand J Med Sci Sports. 2019 May;29(5):638-650. doi: 10.1111/sms.13403. Epub 2019 Mar 7.


This paper aimed to systematically review the evidence base to uncover the key psychosocial factors that underpin adherence to an exercise referral scheme (ERS). Databases PsycINFO, MEDLINE, SPORTDiscus, Web of Science, PubMed, PsycARTICLES, Open Grey, and PsycEXTRA were systematically searched. A parallel results-based convergent synthesis was performed by identifying key themes from quantitative and qualitative studies separately. After applying inclusion and exclusion criteria, the review included 24 eligible studies. Key findings showed intrinsic motivation, psychological need satisfaction, social support, and self-efficacy to be the prominent psychosocial factors associated with ERS adherence. In addition, lower expectations for change when entering the scheme was associated with ERS adherence. This review should serve as a catalyst to provide evidence-based ERS and as such ERS providers should seek to place an emphasis on participants' expectations and beliefs when entering the scheme. Moreover, targeting the key factors of intrinsic motivation, psychological need satisfaction, social support, and self-efficacy throughout the duration of an ERS should serve to facilitate adherence.

Keywords: GP referral; correlates; exercise maintenance; exercise prescription; physical activity.

Publication types

  • Systematic Review

MeSH terms

  • Exercise / psychology*
  • Humans
  • Motivation*
  • Patient Compliance / psychology*
  • Personal Satisfaction
  • Self Efficacy
  • Social Support*