Community-based physical activity interventions in Hertfordshire (UK): a qualitative synthesis of service user and district lead perspectives

The Hertfordshire County Council Place Based Health Inequalities initiative funded 10 community-based physical activity interventions, each aiming to address specific local health inequalities. Target groups were identified using locally defined inclusion criteria. This qualitative analysis explored the perspectives and experiences of service users, representing a diverse range of locally identified priority groups, and leads in district councils regarding the delivery, engagement, and perceived impacts of interventions. Semi-structured interviews were conducted between October 2024 and January 2025 with service users (n = 8) and district leads (n = 8). Of 15 participants who shared demographic information, 12 identified as female, 3 as male, and most as White British. Interviews were audio-recorded, transcribed, coded in Excel, and analysed using inductive framework analysis, with two researchers independently coding a subset of transcripts. Four overarching themes were identified: (i) health empowerment and behaviour change, (ii) benefits and challenges of targeted interventions, (iii) community, motivation and social support, and (iv) delivery challenges and sustainability. Findings revealed that targeted, culturally relevant interventions promoted engagement through representation. Group-based delivery fostered peer support, motivation, and community building. Participants reported increased awareness and control over health behaviours, with perceived improvements in physical fitness, weight management, and mental wellbeing. Challenges included difficulties recruiting participants, limited capacity within district teams, and limited impact due to the small scale and short-term nature of programmes. This study highlights the potential of community-based approaches for promoting engagement in physical activity interventions, while highlighting the need for sustained delivery models and greater local capacity to support long-term health impact.