An evaluation of the Green Prescription programme in Co. Donegal

Abstract

There is a need for innovative, effective, and sustainable initiatives aimed at increasing the physical activity levels of the general population, particularly those who are least active (Hellénius 2011; DoHC, HSE 2009; Durstine et al. 2013). The purpose of this study was to evaluate an adapted model of exercise on prescription – called the Green Prescription Programme - that was piloted in a number of communities in Co. Donegal during 2011 / 2012. The Green Prescription Programme was delivered in partnership between local community groups, local health professionals and the Health Service Executive. The programme involved the referral of suitable patients from health professionals onto a supported community-based walking programme. Community participants could also self-refer onto the programme. This evaluation aimed to (a) determine the feasibility and acceptability of implementing the programme; (b) determine the impacts of programme participation on the participants; (c) to determine the impact of the programme on the referring health professionals and community groups involved; and also aimed to (d) make recommendations for the future development of the programme. A mixed-methods evaluation design was used. Quantitative data included pre- and post-programme measurements of participants’ (i) physical activity levels, (ii) mental wellbeing, (iii) blood pressure, (iv) resting heart rate, (v) waist circumference and (vi) body mass index. Qualitative data was derived from interviews and focus groups with programme participants and those involved in the implementation and delivery of the programme. Interviews were also conducted with a small selection of “key stakeholders and experts”. Key results suggested the programme was acceptable to all those involved and was generally feasible to implement, however some areas of the programme were in need of further development. Programme participants, health professionals and community group leaders self-reported many benefits of programme engagement. Determination of the quantitative impact of the programme was limited by the small number of participants completing post-programme measurements (n=19). However comparison of averaged pre-post-programme scores for these 19 participants showed a significant (p = 0.001) decrease in daily sitting time score from pre- (Mdn = 240 mins/day, IQR = 180) to post-programme (Mdn = 180 mins/day, IQR = 180); a significant (p = .020) increase in mental wellbeing scores from pre- (M = 52.5, SD = 9.7) to post-programme (M = 56.4, SD = 8), and a significant (p = .022) reduction in mean systolic blood pressure from pre- (M = 134.6, SD = 19.2) to post-programme (M = 126.1, SD = 18.1). In conclusion this evaluation suggests the Green Prescription programme has merit and is a potentially viable model for larger-scale rollout. However it is imperative that further outcome evaluation is conducted utilising an experimental evaluation design and a larger sample of participants to produce generalisable results.