Effectiveness and Cost-effectiveness of a Community-based Nine-week Multi-component Group-based Cycling Intervention Versus a Single Cycle Training Session to Increase Cycling Participation: the Cycle Nation Communities Randomised Controlled Trial

Cycling improves physical and mental health, lowering risks of major diseases and reducing stress while enhancing wellbeing and fitness. It is a time-efficient way to increase physical activity and, when replacing motorised transport, reduces air pollution, carbon emissions, and traffic congestion. However, cycling participation in the UK remains low; only 10% of adults cycle at least weekly. This is a missed opportunity to enhance population health, lower health service costs, reduce environmental impact, and improve health related quality of life. Evidence suggests that over 50% of UK adults are interested in cycling more, therefore the potential to increase cycling is substantial.

Non-cyclists report numerous barriers, spanning the individual, social, and environmental factors of the socio-ecological model. While improvements to cycling infrastructure can address some environmental barriers, they alone are insufficient to drive substantial increases in cycling. While many organisations offer standard single or short-term cycling sessions, these often address isolated components rather than taking an integrated approach. In contrast, Cycle Nation is an integrated group-based 9-week multi-component intervention, targeting multiple individual and social barriers over a sustained period to maximise effectiveness.

Initially co-developed and piloted in collaboration with British Cycling and HSBC-UK as a workplace programme for employees, it has since been adapted for community settings in Manchester and Glasgow. Findings of these studies have demonstrated feasibility, acceptability, and short-term effectiveness. However, Cycle Nation has not yet been rigorously tested in a powered randomised controlled trial (RCT), nor had its long-term effectiveness or cost-effectiveness evaluated.

This is a pragmatic, two-arm RCT to assess the effect of the Cycle Nation programme in comparison to a single cycling training session. The interventions will be delivered by community-based cycling delivery partners across Glasgow, UK, with up to six organisations delivering the Cycle Nation programme (intervention) and one delivering the standard single introduction to road cycling session offered by Cycling Scotland (comparison).

The primary objective is to evaluate the effect of the Cycle Nation programme versus a standard single session on the proportion of participants cycling at least weekly at 12 months. Secondary objectives are to a) to evaluate the effect of the Cycle Nation programme versus a standard cycling session on self-reported health and wellbeing at 12 months, b) to evaluate the within-trial cost-effectiveness of the Cycle Nation programme at 12 months (and longer pending within trial findings), c) to assess how (well) Cycle Nation is delivered and examine how the core causal mechanisms function, and d) to determine how contextual factors contribute to variations in outcome and engagement with the Cycle Nation intervention.