Lack of physical activity is a major public health issue in many rich countries. In England, one in four women and one in five men do less than 30 minutes of moderate activity a week.
There are many complex reasons for low levels of physical activity across a population, with a recent academic paper identifying 45 factors – from air quality, to cycling infrastructure, to an individuals’ level of disposable income.
In Gloucestershire, one in five adults do less than 30 minutes of physical activity each week. Active Gloucestershire, a charity based in Gloucester, is carrying out a whole systems approach to increase physical activity called we can move. A whole systems approach looks at the complex web of factors that cause a problem, and then aims to identify parts of the system that can be changed.
We can move aims to help people in Gloucestershire become more physically active. To achieve this, they want to make physical activity the norm by targeting the physical environment including transport infrastructure, workplaces, communities and schools. This requires help and support from the County Council, NHS trusts, the voluntary and community sector and citizens themselves.
NIHR ARC West and colleagues from the University of Bristol’s School for Policy Studies were Active Gloucestershire’s evaluation partner for we can move between April 2019 and April 2021.
The research team aimed to understand two main questions:
We then wanted to use this information to answer a third research question:
The evaluation of a whole systems approach is difficult. To try and comprehensively answer the research questions, we used a range of techniques, including:
We then combined the findings from these methods to answer the research questions.
Another important part of this work was that the lead researcher was embedded in Active Gloucestershire. Before the pandemic, this meant that they spent at least one day a week in the Active Gloucestershire offices to develop a thorough knowledge of we can move. We believe that this embedded role ensured our evaluation was fit for purpose and answered the questions which were most important.
The local context played an important role in helping to shape we can move:
There were several key ingredients enabling we can move to work:
Several challenges were encountered along the way:
The COVID-19 pandemic started in the middle of the we can move evaluation. The pandemic had positive and negative consequences for we can move.
Positive impacts included:
Negative impacts included:
Notable impacts from we can move include:
The evaluation report (PDF) has helped to demonstrate the impact that we can move has had on the local systems, but it has also found several areas of we can move that can be strengthened. The evaluation has been used by Active Gloucestershire and their partners to reflect on, and adapt, the we can move programme.
We also anticipate that this evaluation will be useful nationally for several reasons. First, it adds to the minimal evidence base around the processes and impacts associated with a whole systems approach. And second, it used a range of methods – some of which have not been used before in this context – to answer the research questions. We plan to discuss and share the findings, methodology (how we did things), and implications widely.
The University of Bristol is internationally renowned and one of the very best in the UK, due to its outstanding teaching and research, its superb facilities and highly talented students and staff. Its students thrive in a rich academic environment which is informed by world-leading research. It hosts the Elizabeth Blackwell Institute for Health Research.