PI: Professor Susan Smith, Public Health and Primary Care School of Medicine, TCD
TCD Researchers: Dr Muireann O’Shea, Prof Noel McCarthy, Dr Dylan Creane, Dr Darach Ó Ciardha, Dr Niamh Merriman
Collaborators:
- ExWell Medical
- Tallaght University Hospital
- Health Service Executive, CHO7
Funding: The HSE Community Healthcare Organisation 7 (CHO7) funded participant access to the ExWell programme for a two-year period and an evaluation of the uptake and impact of this service.
Key Objective
This research project aims to evaluate the processes, impact, and feasibility of the ExWell Medical programme, a novel community-based exercise rehabilitation initiative for people living with chronic disease in Ireland.
Research Design
This study is a prospective observational feasibility study using a mixed-methods approach.
Quantitatively, the study will:
- Profile participants referred to ExWell, including chronic disease type, treatment burden, health behaviours, educational attainment, marital status, and socioeconomic status.
- Capture service delivery metrics and assess service processes and efficiency.
- Evaluate the programme’s ability to target selected clinical cohorts.
- Measure readiness of potential participants (i.e. those referred to the programme) to engage with ExWell and the factors influencing uptake, engagement and dropout.
- Assess the impact of engaging in the ExWell programme on participants physical function, patient-reported outcomes, and healthcare utilisation.
Qualitative interviews and focus groups with participants, referrers, clinicians, and ExWell staff will explore experiences of implementation and perceived impact of the ExWell programme.
Impact
Findings will provide essential evidence on the feasibility, implementation, and potential benefits of a community-based physical activity programme for people living with various chronic illnesses in Ireland.
Study Duration: Nov 2022 – Aug 2026
Researchers: Prof Susan Smith (TCD), Dr Paul Doody (TCD), Dr Lisa Kelly (TCD), Dr Fiona Skelly (ExWell Medical), Dr Muireann O’Shea (TCD), Dr John Travers (TCD), Prof Sean Kennelly (TUH), Dr Noel McCaffrey (ExWell Medical), Dr Paul McLoughlin (UCD), Dr David Mockler (TCD).
Collaborators: ExWell Medical
Overview
This scoping review will examine the global evidence on group-based community exercise programmes for adults living with various or multiple non-communicable diseases (NCDs), including cardiovascular disease, diabetes, cancer, chronic respiratory disease, and multimorbidity.
Key Objective
The review aims to comprehensively map and synthesise the available literature on supervised, in-person group exercise programmes delivered in community settings for adults with chronic conditions. It seeks to identify what is currently known, highlight gaps in the evidence, and provide recommendations to inform future research, policy, and service development.
Study Design
Guided by Joanna Briggs Institute methodology and PRISMA-ScR reporting standards, this scoping review involves systematic searches across major international databases, including MEDLINE, Embase, CINAHL, Scopus, Web of Science, the Cochrane Library, and Google Scholar.
Eligible studies include primary research investigating supervised group-based exercise programmes of at least six weeks’ duration delivered in community or outpatient settings to adults aged 18 years and over living with one or more NCDs.
Data will be charted and narratively synthesised, examining programme characteristics, participant profiles, referral pathways, and outcomes such as effectiveness, safety, feasibility, acceptability, engagement, and cost-effectiveness.
Potential Impact
As the global burden of chronic disease continues to rise, there is increasing need for scalable, community-based models of care that support physical activity as medicine. By identifying the strengths and limitations of existing group-based exercise programmes, this review will provide evidence to guide the design, implementation, and evaluation of future services, supporting health systems to better meet the needs of people living with chronic disease.
This doctoral research addresses a key implementation challenge in public health and chronic disease prevention: how to improve recruitment and reach in physical activity programmes for adolescent girls. The project generates policy- and practice-relevant evidence to inform programme design, delivery and targeting, supporting more equitable population health interventions. The work aligns with national policy and strategy regarding physical activity, obesity and chronic disease prevention, and contributes evidence to support effective upstream prevention within Sláintecare.
Supervision team: Assistant Professor Emer Barrett (Primary Supervisor; Discipline of Physiotherapy, Trinity College Dublin) and Professor Catherine Darker (Secondary Supervisor; Trinity College Dublin)
PhD Candidate: Tanya O’Brien
Funding: Research Ireland Enterprise Partnership Scheme Scholarship and the Dublin City Sport & Wellbeing Partnership through the Active Cities project.
Objective:
To identify and evaluate recruitment strategies that improve participation and equity in physical activity programmes for adolescent girls.
Key components:
- Evidence synthesis on recruitment strategies in physical activity interventions
- Applied analysis of recruitment approaches used in real-world programmes
- Translation of findings for programme developers and policymakers
Impact:
Improved guidance for designing and implementing physical activity programmes, supporting national chronic disease prevention policy.
PI: Professor Susan Smith
Co-applicants: Professor Sara Burke, Professor Rónán Collins, Professor Catherine Darker, Dr Paul Doody, Professor Paddy Gillespie, Dr Noel McCaffrey
Collaborators: ExWell, HIQA, Galway University Ireland
Funding:
Health Research Board (HRB) and Department of Health (DOH) Evidence for Policy (EfP) Programme
Objective:
To identify and synthesise the best available national and international evidence to inform policy recommendations on the effective and cost-effective implementation of physical activity in the community to improve health outcomes and quality of life for people living post-stroke in Ireland.
The research also aims to inform the new National Stroke Policy in development by the National Programme for Stroke, led by Co-Applicant Professor Rónán Collins.
Key components:
The INsPIRE Programme aims to provide evidence to inform policy on the effective promotion of physical activity in community settings to improve health outcomes for stroke in Ireland. In particular, the programme will update existing international evidence on the clinical and cost effectiveness of physical activity interventions in stroke, map existing secondary prevention stroke and leverage an existing study evaluating a PA programme for people poststroke (the ExWell Stroke study).
This evidence will be used to undertake a GRADE Evidence-to-Decision Framework for developing policy recommendations based on the RE-AIM and CFIR implementation frameworks. Public and Patient Involvement is interwoven throughout each element of the programme and will be coordinated specifically in a dedicated work package to maximise its impact.
Research design:
- Work Package 1: To synthesise all relevant national and international evidence on clinical and cost effectiveness of interventions to promote physical activity in community settings following a stroke.
- Work Package 2: To map existing community-based physical activity services for people living post-stroke in Ireland, and to evaluate the implementation of a current stroke-specific exercise programme (ExWell Stroke Study) using RE-AIM and CFIR frameworks.
- Work Package 3: To undertake costing and budget impact analysis of physical activity programmes for the secondary prevention of stroke in Ireland.
- Work Package 4: To undertake costing and budget impact analysis of physical activity programmes for the secondary prevention of stroke in Ireland.
- Work Package 5: To work with PPI and other key stakeholders to ensure effective Knowledge Translation and dissemination of evidence and policy recommendations generated through the Programme; using RE-AIM and CFIR to guide relevance and impact.