How can we get EVERYONE exercising?

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‘Exercise is for everyone!’ That was the cry going up in the woodland on Wednesday and I haven’t changed my mind just because it’s Friday, it’s hot and I might be feeling a teensy bit more tempted to lounge on the river bank with an ice cream than go for a brisk walk. But how to engage people in physical activity is, of course, a knotty problem.

How about targeting specific groups or communities?

Researchers from Queen’s University, Belfast have conducted a systematic review to assess the effectiveness of interventions designed to increase physical activity in socio-economically disadvantaged communities – areas where residents are disadvantaged, relative to the wider national population, in terms of income, educational level, ethnic diversity or public housing. All study designs were considered; studies targeting people with a specific disease or condition were excluded. Studies were categorised according to whether interventions targeted individuals, groups or communities. Twenty-seven studies were suitable for inclusion in the review, including 20 from the US and two from the UK. Here’s what they found:

  • Group-based interventions (18 studies) were effective for adults but not children
  • Limited evidence from five non-randomised studies suggested that community-wide interventions produced small changes in physical activity
  • Interventions underpinned by any theoretical framework, compared to none, were more likely to be effective
  • Several effective interventions included education, physical activity and social support components

But

  • There was insufficient evidence on interventions targetting individuals to make any recommendations
  • The quality of the evidence is not high. The review included studies of a variety of designs and many had small sample sizes, were run for a short period of time and had other methodological problems
  • Most of the studies were conducted in the US with ethnic minority populations and most of the group-based interventions for children targeted overweight African-American girls. Most participants across the review studies were female. This means the results of the review may not be generalisable to other disadvantaged populations

The authors concluded:

“Multi-component adult group-based interventions with theoretical frameworks are most effective in increasing physical activity in socio-economically disadvantaged communities.”

But how effective are they, if at all?

The authors note that a Cochrane review published last year, which included 25 studies on community-wide interventions to increase physical activity with a minimum follow-up of six months, found inconsistent results between studies and overall did not find evidence that multi-component community-wide interventions increased physical activity. However, the poor quality of the studies was a major problem and both reviews have highlighted the need for more well-designed studies in this area.

So while we wait for better research to be done, please take it from me that exercise is for YOU.

Links:

Cleland CL, Tully M, Keeb F, Cupples ME. The effectiveness of physical activity interventions in socio-economically disadvantaged communities: A systematic review. Preventive Medicine 2012, 13 April [Epub ahead of print]

Baker PRA, Francis DP, Soares J, Weightman AL, Foster C. Community wide interventions for increasing physical activity. Cochrane Database of Systematic Reviews 2011, Issue 4. Art. No.: CD008366. DOI: 10.1002/14651858.CD008366.pub2.

The NHS Choices website has lots of information and suggestions about exercise.

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Sarah Chapman

My name is Sarah Chapman. I have worked on systematic reviews and other types of research in many areas of health for the past 17 years, for the Cochrane Collaboration and for several UK higher education institutions including the University of Oxford and the Royal College of Nursing Institute. I also have a background in nursing and in the study of the History of Medicine.

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