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Meta-Analysis
. 2005 Jan 25;2005(1):CD003180.
doi: 10.1002/14651858.CD003180.pub2.

Interventions for promoting physical activity

M Hillsdon  1 , C Foster, M Thorogood
Affiliations
Meta-Analysis

Interventions for promoting physical activity

M Hillsdon et al. Cochrane Database Syst Rev. .

Abstract

Background: Little is known about the effectiveness of strategies to enable people to achieve an increase in their physical activity.

Objectives: To assess the effects of interventions for promoting physical activity in adults aged 16 years and older, not living in an institution.

Search strategy: We searched CENTRAL (Issue 4, 2001), MEDLINE, EMBASE, CINAHL, PsychLIT, BIDS ISI, SPORTDISCUS, SIGLE, SCISEARCH (from earliest date available to December 2001) and reference lists of articles.

Selection criteria: Randomised, controlled, trials comparing 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 (11 studies; 3940 participants) was positive and moderate, with a pooled standardised mean difference of 0.31 (95% CI 0.12 to 0.50), as was the effect on cardio-respiratory fitness (7 studies; 1406 participants) pooled SMD 0.4 (95% CI 0.09 to 0.70). The effect of interventions in achieving a predetermined threshold of physical activity (6 studies; 2313 participants) was not significant with an odds ratio of 1.30 (95% CI 0.87 to 1.95). 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 and cardio-respiratory fitness, but not on achieving a predetermined level of physical activity. 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.

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Conflict of interest statement

The authors of this review are also authors of one of the included studies (Hillsdon 2002).

Figures

1
1
QUOROM statement
1.1
1.1. Analysis
Comparison 1 Pooled effects, Outcome 1 Studies with continuous data for self‐reported physical activity.
1.2
1.2. Analysis
Comparison 1 Pooled effects, Outcome 2 Studies with dichotomous data for self‐reported physical activity.
1.3
1.3. Analysis
Comparison 1 Pooled effects, Outcome 3 Studies with continuous data for cardio‐respiratory fitness.
2.1
2.1. Analysis
Comparison 2 Sensitivity anaylsis, Outcome 1 Study quality ‐ continuous data for self‐reported physical activity.
2.2
2.2. Analysis
Comparison 2 Sensitivity anaylsis, Outcome 2 Study quality ‐ dichotomous data for self‐reported physcial activity.
2.3
2.3. Analysis
Comparison 2 Sensitivity anaylsis, Outcome 3 Study quality ‐ continuous data for cardio‐respiratory fitness.
3.1
3.1. Analysis
Comparison 3 Sub group analysis, Outcome 1 Nature of direction ‐ self‐reported physical activity.
3.2
3.2. Analysis
Comparison 3 Sub group analysis, Outcome 2 Nature of direction ‐ cardio‐respiratory fitness.
3.3
3.3. Analysis
Comparison 3 Sub group analysis, Outcome 3 Frequency of intervention occasions ‐ self‐reported physical activity.
3.4
3.4. Analysis
Comparison 3 Sub group analysis, Outcome 4 Frequency of intervention occasions ‐ dichotomous data.
3.5
3.5. Analysis
Comparison 3 Sub group analysis, Outcome 5 Frequency of intervention occasions ‐ cardio‐respiratory fitness.
3.6
3.6. Analysis
Comparison 3 Sub group analysis, Outcome 6 Frequency of follow‐up ‐ self‐reported physical activity.
3.7
3.7. Analysis
Comparison 3 Sub group analysis, Outcome 7 Frequency of follow‐up ‐ cardio‐respiratory fitness.
3.8
3.8. Analysis
Comparison 3 Sub group analysis, Outcome 8 Frequency of follow‐up ‐ dichotomous data.
3.9
3.9. Analysis
Comparison 3 Sub group analysis, Outcome 9 Degree of supervision ‐ self‐reported physical activity.
3.10
3.10. Analysis
Comparison 3 Sub group analysis, Outcome 10 Degree of supervison ‐ cardio‐respiratory fitness.
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Update of

  • doi: 10.1002/14651858.CD003180

References

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Hirvensalo 2003 {published data only}
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Hopman‐Rock 2002 {published data only}
    1. Hopman‐Rock M, Westhoff MH. Health education and exercise stimulation for older people: development and evaluation of the program "Healthy and Vital" [Gezondheidsvoorlichting en bewegingsstimulering voor ouderen: ontwikkeling en evaluatie van het programma "Gezond & Vitaal"]. Tijdschrift voor Gerontologie en Geriatrie 2002;33(2):56‐63. - PubMed
Huang 2002 {published data only}
    1. Huang LH, Chen SW, Yu YP, Chen PR, Lin YC. The effectiveness of health promotion education programs for community elderly. Journal of Nursing Research 2002;10(4):261‐70. - PubMed
Humpel 2004 {published data only}
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Kaukiainen 2002 {published data only}
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Keele‐Smith 2003 {published data only}
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Kennedy 2003 {published data only}
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King 1995 {published data only}
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King 1997 {published data only}
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King 2000 {published data only}
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Kirk‐Gardner 2003 {published data only}
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Koffman 2001 {published data only}
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Kohno 2002 {published data only}
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Marcus 1993 {published data only}
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Marcus 1998b {published data only}
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Marshall 2003b {published data only}
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Napolitano 2003 {published data only}
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