Comparing practice characteristics and quality outcomes between parkrun and non-parkrun GP practices in England, with a focus on socioeconomic equity: a cross-sectional study

Abstract Background Physical activity has wide-ranging benefits, and evidence supports the effectiveness of its promotion in primary care. The parkrun practice initiative is a voluntary social prescribing initiative encouraging General Practitioner (GP) practices to promote participation in free, weekly community-based physical activity events. Although potential benefits have been reported, the equity of the initiative’s uptake and impact remains unexplored. The aim of this study was to compare characteristics and quality outcomes between parkrun and non-parkrun GP practices in England, with particular attention to socioeconomic equity. Methods A cross-sectional observational study of English GP practices using routinely collected, publicly available data. Data were analysed for 6,185 practices, of which 1,665 were parkrun practices. Outcomes included Quality and Outcomes Framework (QOF) points (financial incentive-based quality indicators related to the delivery of evidence-based care), patient satisfaction (national patient experience survey), and Care Quality Commission (CQC) ratings (regulatory practice quality ratings). Multivariable regression models were performed, adjusting for socioeconomic deprivation, list size, population demographics, and urban–rural classification. Moderation and deprivation-stratified analyses explored equity effects. Results parkrun practices were more likely to be located in less socioeconomically deprived areas and serve populations with higher proportions of older and White patients; statistically significant differences were observed across all practice characteristic variables except urban/rural classification. Regarding practice quality outcomes, after adjustment, compared to non-parkrun practices, parkrun practices were associated with statistically significant higher QOF scores (mean difference +0.92 percentage points, p<0.001), higher patient satisfaction (+3.1 percentage points, p<0.001), and increased odds of a higher CQC rating (OR 1.32, p<0.001). Interaction analyses found no evidence that these associations differed systematically by deprivation, although stratified analyses suggested weaker or absent effects at the extremes of deprivation. Conclusions Affiliation with the parkrun practice initiative is associated with modestly better practice quality outcomes, but uptake is socially patterned. Without targeted adaptation and support, the initiative may risk reinforcing existing inequalities.