SeriesEvidence-based intervention in physical activity: lessons from around the world
Section snippets
Importance of physical activity promotion
Scientific guidelines issued by various international bodies, national centres and institutes, and professional organisations have documented that regular physical activity protects against coronary heart disease, type 2 diabetes, some cancers, hypertension, obesity, clinical depression, and other chronic disorders.1, 2, 3, 4, 5 These findings have been reiterated in Lee and colleagues' systematic review of the evidence.6 Therefore, the substantial potential benefits of promotion of physical
Search strategy and selection criteria
Here, we summarise representative evidence-based physical activity interventions from throughout the world that are linked to a broad understanding of health promotion and disease prevention at the national, state and regional, and local levels. We did a systematic review of reviews to assess the present evidence. We searched the Database of Abstracts of Reviews of Effects (DARE), the Cochrane library, TRIP, PubMed (Medline), the American Psychological Association, National Guidelines
Campaigns and informational approaches
A recommended strategy within this domain is use of community-wide campaigns (appendix),36 such as the Stanford heart disease prevention programme38 and the Wheeling Walks intervention.39 These campaigns represent large-scale, high-intensity, high-visibility programming and often use television, radio, newspapers, and other media to raise awareness, disseminate targeted health messages to specific segments of the population (ie, segmented messages), and reinforce behaviour change. This strategy
Behavioural and social approaches
Individually adapted programmes to change health behaviour are characterised by a multicomponent intervention approach, and aim to have participants incorporate physical activity into their daily routines.36 Goal setting, social support, and behavioural reinforcement through self-reward, structured problem solving, and relapse prevention are examples of this type of intervention.36 Such programmes can be delivered in group settings or by email, internet, mail, or telephone, or by all four
Policy and environmental approaches
Walking and biking trails and exercise facilities can be created or enhanced to promote physical activity, and access to existing facilities can be increased with a reduction in structural and environmental barriers (eg, increased safety, improved affordability; appendix).36 Environmental and policy initiatives are often supported by training of personnel or participants, or both, provision of social support, and further integration of these structures, facilities, and programmes into
Translation, adaptation, capacity building, and keys to success
On the basis of existing evidence, an interesting pattern seems to be emerging, which emphasises important regional and cultural differences in how physical activity promotion is being approached around the world. The best options for interventions aimed at communities and individuals are probably dictated by local region and culture for some populations and settings. For example, previous reviews of work from Latin America41 have identified a high prevalence of community-based interventions
Limitations and next steps
Several limitations are associated with our review of reviews. Although we attempted to identify reports from around the world irrespective of language, we have mainly drawn information from reports in English, Spanish, and Portuguese. Additionally, we did not attempt to complete a thorough search of the grey literature. Much of the published work did not include measures of external validity and hence restricted the generalisability of the findings to other settings and countries. Despite
References (83)
- et al.
The effectiveness of interventions to increase physical activity: a systematic review
Am J Prev Med
(2002) - et al.
Cost effectiveness of community-based physical activity interventions
Am J Prev Med
(2008) - et al.
Wheeling Walks: a community campaign using to encourage walking among sedentary older adults
Prev Med
(2002) - et al.
Evaluation of mass media campaigns for physical activity
Eval Program Plann
(2006) - et al.
Did augmenting the VERB Campaign advertising in select communities have an effect on awareness, attitudes, and physical activity?
Am J Prev Med
(2008) - et al.
Testing a hierarchy of effects model: pathways from awareness to outcomes in the VERB campaign 2002–2003
Am J Prev Med
(2008) - et al.
Point-of-decision prompts to increase stair use: a systematic review update
Am J Prev Med
(2010) - et al.
Cost-effectiveness of lifestyle and structured exercise interventions in sedentary adults: results of project ACTIVE
Am J Prev Med
(2000) - et al.
Physical fitness gains following simple environmental change
Am J Prev Med
(1991) - et al.
Improving health through policies that promote active travel: a review of evidence to support integrated health impact assessment
Environ Int
(2011)
Public health benefits of strategies to reduce greenhouse-gas emissions: urban land transport
Lancet
Global recommendations on physical activity for health
Start active, stay active: a report on physical activity for health from the four home countries' Chief Medical Officers
European Union physical activity guidelines
Physical Activity Guidelines Advisory Committee report, 2008
Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association
Circulation
Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy
Lancet
The Toronto charter for physical activity: a global call to action
The future of public health
Traditional epidemiology, modern epidemiology, and public health
Am J Public Health
Assessment of validity of the National Public Health Performance Standards: the local public health performance assessment instrument
Public Health Rep
Workshop on epidemiologic and public health aspects of physical activity and exercise: a summary
Public Health Rep
Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine
JAMA
Correlates of adults' participation in physical activity: review and update
Med Sci Sports Exerc
Ecological models of health behavior
Correlates of physical activity: why are some people are physically active and others not?
Lancet
A review of collaborative partnerships as a strategy for improving community health
Ann Rev Public Health
The value and challenges of participatory research: strengthening its practice
Ann Rev Public Health
A guide for population-based approaches to increasing levels of physical activity: implementation of the WHO global strategy on diet, physical activity, and health
The role of the public health sector in promoting physical activity: national, state, and local applications
J Phys Act Health
Physical activity
Behavioral counseling to promote physical activity and a healthful diet to prevent cardiovascular disease in adults: update of the evidence for the US Preventive Services Task Force
Evidence-based public health: a fundamental concept for public health practice
Ann Rev Public Health
Accelerating evidence reviews and broadening evidence standards to identify effective, promising, and emerging policy and environmental strategies for prevention of childhood obesity
Annu Rev Public Health
Effect of community health education on physical activity knowledge, attitudes, and behaviour: the Stanford Five-City Project
Am J Epidemiol
Community wide interventions for increasing physical activity
Cochrane Database Syst Rev
Physical activity interventions in Latin America: a systematic review
Am J Prev Med
Serial mass-media campaigns to promote physical activity: reinforcing or redundant?
Am J Public Health
Efeitos de um programa de orientação de atividade física e nutricional sobre o nível de atividade física de mulheres fisicamente ativas de 50 a 72 anos de idade
Revista Brasileirade Medicina do Esporte
Increasing physical activity with point-of-choice prompts: a systematic review
Scand J Public Health
- †
Members listed at end of paper