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

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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
Date:	14 November 2007
Number:	No.4
Number of Pages:	74
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:	Calfas 2000 {published data only} Calfas KJ, Sallis JF, Nichols JF, Sarkin JA, Johnson MF, Caparosa S, et al.Project GRAD: two-year outcomes of a randomized controlled physical activity intervention among young adults. Graduate Ready for Activity Daily. American Journal of Preventive Medicine 2000;18 (1):28–37. [MEDLINE: 2910]. Cunningham 1987 {published data only} Cunningham DA, Rechnitzer PA, Howard JH, Donner AP. Exercise training of men at retirement: a clinical trial. Journal of Gerontology 1987;42(1):17–23. [MEDLINE: 28197]. Dubbert 2002 {published and unpublished data} Dubbert PM, Cooper KM, Kirchner KA, Meydrech EF, Bilbrew D. Effects of nurse counseling on walking for exercise in elderly primary care patients. Journals of Gerontology Series A-Biological Sciences & Medical Sciences 2002;57(11):M733–40. Elley 2003 {published data only} Elley CR, KerseN, Arroll B, Robinson E. Effectiveness of counselling patients on physical activity in general practice: cluster randomised controlled trial. BMJ 2003;326(7393):793–800. Goldstein 1999 {published data only} Goldstein MG, Pinto BM,Marcus BH. Physician based physical activity counselling formiddle aged and older adults: a randomised trial. Annals of Behavioral Medicine 1999;21:40–7. [MEDLINE: 28230]. Green 2002 {published data only} Green B,McAffee T,HindmarshM,Madsen L, CaplowM, Buist D. Effectiveness of telephone support in increasing physical activity levels in primary care patients. American Journal of Preventive Medicine 2002;22(3):177–83. Harland 1999 {published data only} Harland J, WhiteM,Drinkwater C, Chinn D, Farr L,Howel D. The Newcastle exercise project: a randomised controlled trial of methods to promote physical activity in primary care. BMJ 1999;319(7213): 828–32. [MEDLINE: 3343]. Hillsdon 2002 {published data only} Hillsdon M, Thorogood M, White IR, Foster C. 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[MEDLINE: 28216]. King 1988b {published data only} 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]. Kriska 1986 {published data only} 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. 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URI:	http://wrap.warwick.ac.uk/id/eprint/263

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