Evaluation of the impact of a 20-week exercise referral scheme on Mauritian adults diagnosed with non-communicable diseases

Abstract

The escalating prevalence of non-communicable diseases (NCD) presents a concern in Mauritius. These diseases, caused by many factors, reflect the social, economic and environmental conditions within which people live and work. Type 2 diabetes mellitus, hypertension and obesity are the most prevalent among Mauritian adults. Within the framework of a comprehensive systems approach aiming at addressing the social determinants of health, there is a need for customised strategies for both management and prevention of non-communicable diseases. One such example is exercise referral. Exercise referral schemes (ERS) represent an emerging tool for helping people become more physically active and healthier. Evidence of their effectiveness is equivocal and lacks contextual insight into their value in a Mauritian context. Hence, this study serves to bridge this gap. We report the outcomes of a 20-week ERS. Two hundred sixty consenting adults recruited from Area Health Centres (AHC) and Mediclinic’s around Mauritius were assigned to one of two groups: intervention group (ERS + guidance and support by exercise referral consultant) or control group (exercise ‘advice’ from a general practitioner). Body mass index (BMI), grip strength, waist circumference, fasting blood sugar (FBS), HbA1c, lipid profile and blood pressure were measured at week 0, 10 and 20. This quasi-experimental longitudinal study successfully demonstrated improvements in parameters associated with risk factors for coronary heart disease, particularly among women in the intervention group. Significant reductions in weight, waist circumference, FBS and BMI at week 10 and 20 were noted. A less pronounced decline in parameters was observed in men, except for waist circumference, which reached near significance (p = 0.076). Using female participants as a primary focal point, this study supports the notion of exercise referral as part of a holistic treatment plan to control NCDs. We advocate future ERS initiatives prioritise a patient-centred comprehensive approach in design and implementation to ensure successful outcomes.