{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:51:54Z","timestamp":1792050714278,"version":"4.4.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Health Promot"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine whether baseline body mass index (BMI) moderates BMI changes following completion of an exercise referral scheme (ERS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data from the National ReferAll Database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample<\/jats:title>\n                    <jats:p>634 adults out of 39,283 (64% female; mean age 54 \u00b1 15\u00a0years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Participants completed a community-based ERS involving physical activity counseling and supervised exercise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>\n                      BMI was calculated as weight (kg) divided by height (m\n                      <jats:sup>2<\/jats:sup>\n                      ) and participants were categorized by BMI: normal weight (&lt;25.0\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), overweight (25.0-29.9\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), and obesity classes I (30.0-34.9\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), II (35.0-39.9\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), and III (\u226540.0\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis<\/jats:title>\n                    <jats:p>A 5 \u00d7 2 mixed methods analysis of covariance, adjusted for age, sex, ERS type, and follow-up duration examined BMI changes over time by group. Linear regression assessed the relation between baseline BMI and BMI change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline BMI predicted BMI reduction (\u03b2 = \u22120.07 \u00b1 0.01, 95% CI: \u22120.09 to \u22120.04,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Compared to the normal weight group, individuals with obesity classes I\u2013III had significantly greater reductions in BMI (mean difference range: 0.83-1.01\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). No significant difference was observed between normal weight and overweight participants (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .207).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides evidence that ERS can be effective in improving BMI outcomes among individuals who have an elevated initial BMI. These findings support the continued development and refinement of ERS as a scalable public health strategy to promote weight-related improvements.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08901171261419478","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T17:48:52Z","timestamp":1769104132000},"page":"941-946","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Initial Weight Status Moderates the Impact of Exercise Referral Schemes on Improving Patients\u2019 Body Mass Index"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7520-3515","authenticated-orcid":false,"given":"Carson","family":"Halliwell","sequence":"first","affiliation":[{"name":"Dalhousie University"},{"name":"Centre de Formation M\u00e9dicale du Nouveau-Brunswick"},{"name":"Sherbrooke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2829-8219","authenticated-orcid":false,"given":"Renaud","family":"Tremblay","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Sherbrooke"},{"name":"CIUSSS de l\u2019Estrie-CHUS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0268-0762","authenticated-orcid":false,"given":"Jonathon R.","family":"Fowles","sequence":"additional","affiliation":[{"name":"Acadia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8573-1413","authenticated-orcid":false,"given":"Ryan E. R.","family":"Reid","sequence":"additional","affiliation":[{"name":"St Francis Xavier University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1719-4799","authenticated-orcid":false,"given":"Rebecca","family":"Moyer","sequence":"additional","affiliation":[{"name":"Dalhousie University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taniya S.","family":"Nagpal","sequence":"additional","affiliation":[{"name":"University of Alberta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0665-5062","authenticated-orcid":false,"given":"Myles W.","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Centre de Formation M\u00e9dicale du Nouveau-Brunswick"},{"name":"Sherbrooke University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20210205"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/oby.23161"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2020.09.010"},{"key":"e_1_3_5_5_2","volume-title":"World Obesity Atlas 2023","author":"World Obesity","unstructured":"World Obesity. 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