‘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.