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Interventions for promoting physical activity (review)

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Foster, C., Hillsdon, Melvyn and Thorogood, Margaret. (2007) Interventions for promoting physical activity (review).

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Official URL: http://dx.doi.org/10.1002/14651858.CD003180.pub2.

Abstract

Background
Little is known about the effectiveness of strategies to enable people to achieve and maintain recommended levels of physical activity.
Objectives
To assess the effectiveness of interventions designed to promote physical activity in adults aged 16 years and older, not living in an
institution.
Search strategy
We searched The Cochrane Library (issue 1 2005), MEDLINE, EMBASE, CINAHL, PsycLIT, BIDS ISI, SPORTDISCUS, SIGLE,
SCISEARCH(fromearliest dates available toDecember 2004). Reference lists of relevant articles were checked.No language restrictions were applied.
Selection criteria
Randomised controlled trials that compared different interventions to encourage sedentary adults not living in an institution to become physically active. Studies required a minimum of six months follow up from the start of the intervention to the collection of final data
and either used an intention-to-treat analysis or, failing that, had no more than 20% loss to follow up.
Data collection and analysis
At least two reviewers independently assessed each study quality and extracted data. Study authors were contacted for additional information where necessary. Standardised mean differences and 95% confidence intervals were calculated for continuous measures of
self-reported physical activity and cardio-respiratory fitness. For studies with dichotomous outcomes, odds ratios and 95% confidence intervals were calculated.
Main results
The effect of interventions on self-reported physical activity (19 studies; 7598 participants) was positive and moderate (pooled SMD random effects model 0.28 95%CI 0.15 to 0.41) as was the effect of interventions (11 studies; 2195 participants) on cardio-respiratory fitness (pooled SMD random effects model 0.52 95% CI 0.14 to 0.90). There was significant heterogeneity in the reported effects as
well as heterogeneity in characteristics of the interventions. The heterogeneity in reported effects was reduced in higher quality studies,when physical activity was self-directed with some professional guidance and when there was on-going professional support.
Authors’ conclusions
Our review suggests that physical activity interventions have a moderate effect on self-reported physical activity, on achieving a predetermined level of physical activity and cardio-respiratory fitness. Due to the clinical and statistical heterogeneity of the studies, only limited conclusions can be drawn about the effectiveness of individual components of the interventions. Future studies should provide greater detail of the components of interventions.

Item Type:

Journal Article

Subjects:

R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine

Divisions:

Faculty of Medicine > Warwick Medical School

Library of Congress Subject Headings (LCSH):

Exercise -- Health aspects

Publisher:

John Wiley and Sons

ISBN:

1469-493X

Official Date:

14 November 2007

Dates:

Date	Event
14 November 2007	["eprint_fieldopt_dates_date_type_modified" not defined]

Number:

No.4

Number of Pages:

Identification Number:

10.1002/14651858.CD003180.pub2.

Status:

Not Peer Reviewed

Access rights to Published version:

Restricted or Subscription Access

Funder:

British Heart Foundation

Grant number:

2006-2011 UK, PG/2001089 UK

Version or Related Resource:

Previously published in: Cochrane Database of Systematic Reviews 2005, Issue 1.

References:

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BH. Population-based randomized controlled trial of a stage-targeted
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25(3):194–202.
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Marshall AL, Bauman AE, Owen N, Booth ML, Crawford D, Marcus
BH. Reaching out to promote physical activity in Australia: a
statewide randomized controlled trial of a stage-targeted intervention.
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Norris SL, Grothaus LC, Buchner DM, Pratt M. Effectiveness
of physician-based assessment and counseling for exercise in a
staff model HMO. PreventiveMedicine 2000;30(6):513–23. [MEDLINE:
468].
Petrella 2003 {published data only}
Petrella RJ, Koval JJ, Cunningham DA, Paterson DH. Can primary
care doctors prescribe exercise to improve fitness? The step test exercise
prescription (STEP) project. American Journal of Preventive
Medicine 2003;24(4):316–22.
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Pinto BM, Friedman R,Marcus BH, Kelley H, Tennstedt S,Gillman
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care: The Activity Counseling Trial: A randomized controlled
trial. JAMA 2001;286(6):677–87. [MEDLINE: 7812].
Simons-Morton 2001b {published data only}
Simons-Morton DG, Blair SN, King AC, Morgan TM, Applegate
WB, O’ Toole M, et al.Effects of physical activity counseling in primary
care: The Activity Counseling Trial: A randomized controlled
trial. JAMA 2001;286(6):677–87.
Smith 2000 {published data only}
Smith BJ, Bauman AE, Bull FC, Booth ML, Harris MF. Promoting
physical activity in general practice: a controlled trial of written advice
and information materials. British Journal of Sports Medicine 2000;
34(4):262–7. [MEDLINE: 427].
SSCT 2000 {published data only}
Fujita K, Nagatomi R, Hozawa A, Ohkubo T, Sato K, Anzai Y, et
al.Effects of exercise training on physical activity in older people:
a randomized controlled trial. Journal of Epidemiology 2003;13(2):
120–6.
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et al.Randomized controlled trial of exercise training for older people
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2867].
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Stevens W, Hillsdon M, Thorogood M, McArdle D. Cost-effectiveness
of a primary care based physical activity intervention in 45-74
year old men and women: a randomised controlled trial. British Journal
of Sports Medicine 1998;32(3):236–41. [MEDLINE: 3561].
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Stewart AL, Verboncoeur CJ,McLellan BY, Gillis DE, Rush S,Mills
KM, et al.Physical activity outcomes of CHAMPS II: a physical activity
promotion program for older adults. Journals of Gerontology
Series A-Biological Sciences&Medical Sciences 2001;56(8):M465–70.
[MEDLINE: 114].
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Andersen LB, Klausen K,Nisbeth O. One-year effect of health counseling
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sundhedsvejledning pa livsstil og risikofaktorer for hjertesygdom].
Ugeskrift for Laeger 2002;164(13):1814–8.
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Aoun S, Johnson L.Men’s health promotion by general practitioners
in a workplace setting. Australian Journal of Rural Health 2002;10
(6):268–72.
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King AC, Taylor CB,HaskellWL, DeBusk RF. Strategies for increasing
early adherence to and long-term maintenance of home-based
exercise training in healthy middle-aged men and women. American
Journal of Cardiology 1988;61(8):628–32. [MEDLINE: 28216].
King 1991 {published data only}
King AC,HaskellWL, TaylorCB, KraemerHC, DeBusk RF.Groupvs
home-based exercise training in healthy older men and women.
A community-based clinical trial. JAMA 1991;266(11):1535–42.
[MEDLINE: 28206].
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Kriska AM, Bayles C, Cauley JA, LaPorte RE, Sandler RB, Pambianco
G. A randomized exercise trial in older women: increased
activity over two years and the factors associated with compliance.
Medicine & Science in Sports & Exercise 1986;18(5):557–62. [MEDLINE:
28207].
Lamb 2002 {published data only}
Lamb SE, Bartlett HP, Ashley A, Bird W. Can lay-led walking programmes
increase physical activity in middle aged adults? A randomised
controlled trial. Journal of Epidemiology & Community
Health 2002;56:246–52.
Lombard 1995 {published data only}
Lombard DN, Lombard TN, Winett RA. Walking to meet health
guidelines: the effect of prompting frequency and prompt structure.
Health Psychology 1995;14(2):164–70. [MEDLINE: 28185].
Marshall 2003a {published and unpublished data}
MarshallAL, BaumanAE, OwenN, BoothML,Crawford D,Marcus
BH. Population-based randomized controlled trial of a stage-targeted
physical activity intervention. Annals of Behavioral Medicine 2003;
25(3):194–202.
Marshall 2004 {published data only}
Marshall AL, Bauman AE, Owen N, Booth ML, Crawford D, Marcus
BH. Reaching out to promote physical activity in Australia: a
statewide randomized controlled trial of a stage-targeted intervention.
American Journal of Health Promotion 2004;18:283–7.
Norris 2000 {published data only}
Norris SL, Grothaus LC, Buchner DM, Pratt M. Effectiveness
of physician-based assessment and counseling for exercise in a
staff model HMO. PreventiveMedicine 2000;30(6):513–23. [MEDLINE:
468].
Petrella 2003 {published data only}
Petrella RJ, Koval JJ, Cunningham DA, Paterson DH. Can primary
care doctors prescribe exercise to improve fitness? The step test exercise
prescription (STEP) project. American Journal of Preventive
Medicine 2003;24(4):316–22.
Pinto 2002 {published data only}
Pinto BM, Friedman R,Marcus BH, Kelley H, Tennstedt S,Gillman
MW. Effects of a computer-based, telephone counseling system on
physical activity. American Journal of Preventive Medicine 2002;23
(2):113–20.
Reid 1979 {published data only}
Reid EL,Morgan RW. Exercise prescription: a clinical trial. American
Journal of Public Health 1979;69(6):591–5. [MEDLINE: 516].
Resnick 2002a {published data only}
Resnick B. Testing the effect of the WALC intervention on exercise
adherence in older adults. Journal of Gerontological Nursing 2002;28
(6):40–9.
Simons-Morton 2001a {published data only}
Simons-Morton DG, Blair SN, King AC, Morgan TM, Applegate
WB, O’ Toole M, et al.Effects of physical activity counseling in primary
care: The Activity Counseling Trial: A randomized controlled
trial. JAMA 2001;286(6):677–87. [MEDLINE: 7812].
Simons-Morton 2001b {published data only}
Simons-Morton DG, Blair SN, King AC, Morgan TM, Applegate
WB, O’ Toole M, et al.Effects of physical activity counseling in primary
care: The Activity Counseling Trial: A randomized controlled
trial. JAMA 2001;286(6):677–87.
Smith 2000 {published data only}
Smith BJ, Bauman AE, Bull FC, Booth ML, Harris MF. Promoting
physical activity in general practice: a controlled trial of written advice
and information materials. British Journal of Sports Medicine 2000;
34(4):262–7. [MEDLINE: 427].
SSCT 2000 {published data only}
Fujita K, Nagatomi R, Hozawa A, Ohkubo T, Sato K, Anzai Y, et
al.Effects of exercise training on physical activity in older people:
a randomized controlled trial. Journal of Epidemiology 2003;13(2):
120–6.
Tsuji I, Tamagawa A, Nagatomi R, Irie N, Ohkubo T, Saito M,
et al.Randomized controlled trial of exercise training for older people
(Sendai Silver Center Trial; SSCT): study design and primary
outcome. Journal of Epidemiology 2000;10(1):55–64. [MEDLINE:
2867].
Stevens 1998 {published data only}
Stevens W, Hillsdon M, Thorogood M, McArdle D. Cost-effectiveness
of a primary care based physical activity intervention in 45-74
year old men and women: a randomised controlled trial. British Journal
of Sports Medicine 1998;32(3):236–41. [MEDLINE: 3561].
Stewart 2001 {published data only}
Stewart AL, Verboncoeur CJ,McLellan BY, Gillis DE, Rush S,Mills
KM, et al.Physical activity outcomes of CHAMPS II: a physical activity
promotion program for older adults. Journals of Gerontology
Series A-Biological Sciences&Medical Sciences 2001;56(8):M465–70.
[MEDLINE: 114].
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Andersen 1999
Andersen RE, Wadden TA, Bartlett SJ, Zemel B, Verde TJ, Franckowiak
SC. Effects of lifestyle activity vs structured aerobic exercise in
obese women. JAMA 1999;281(4):335–40. [MEDLINE: 26884].
Andersen 2002
Andersen LB, Klausen K,Nisbeth O. One-year effect of health counseling
on life style and risk factors of heart disease [Et ars effekt af
sundhedsvejledning pa livsstil og risikofaktorer for hjertesygdom].
Ugeskrift for Laeger 2002;164(13):1814–8.
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