The effect of community and family interventions on young people’s physical activity levels: A review of reviews and updated systematic review

MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
British Journal of Sports Medicine (Impact Factor: 5.03). 09/2011; 45(11):914-22. DOI: 10.1136/bjsports-2011-090187
Source: PubMed


Next to the school environment, the family and community environment are key for young people's behaviour and for promoting physical activity (PA).
A review of reviews was conducted, after which a literature search was conducted (in PubMed, Scopus and PsychInfo) from August 2007 (search date of the most recent review) to October 2010. Inclusion criteria were study population aged 18 years or younger, controlled trial, no PA control condition, PA promotion intervention and reported analyses of a PA-related outcome. Methodological quality was assessed, and data on intervention details, methods and effects on primary and secondary outcomes (PA, body composition and fitness) were extracted.
Three previous reviews were reviewed, including 13 family-based and three community-based interventions. Study inclusion differed for each review, but all concluded that the evidence was limited, although the potential of family-based interventions delivered in the home and including self-monitoring was highlighted. A further six family-based and four community-based interventions were included in the updated review, with a methodological quality score ranging from 2 to 10 and five studies scoring 6 or higher. Significant positive effects on PA were observed for one community-based and three family-based studies. No distinctive characteristics of the effective interventions compared with those that were ineffective were identified.
The effect of family- and community-based interventions remains uncertain despite improvements in study quality. Of the little evidence of effectiveness, most comes from those targeted at families and set in the home. Further detailed research is needed to identify key approaches for increasing young people's PA levels in family and community settings.

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    • "Finally, while searching for PA studies, there was no consideration of publication bias, and it is possible that not all articles related to the interventions reviewed (i.e., companion papers) were recovered. Conclusions Numerous systematic reviews have focused on the efficacy of PA interventions in youth; however, many have commented on the potential lack of generalizability of their findings (e.g., Camacho-Miñano et al., 2011; Kriemler et al., 2011; van Sluijs et al., 2011 "
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    ABSTRACT: An identified limitation of existing reviews of physical activity (PA) interventions in school-aged youth is the lack of reporting on issues related to the translatability of the research into health promotion practice. This review used the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance) framework to determine the extent to which intervention studies promoting PA in youth report on factors that inform generalizability across settings and populations. and Results A systematic search for controlled interventions conducted within the last ten years identified 50 studies that met the selection criteria. Based on RE-AIM criteria, most of these studies focused on statistically significant findings and internal validity rather than on issues of external validity. Due to this lack of information, it is difficult to determine whether or not reportedly successful interventions are feasible and sustainable in an uncontrolled, real-world setting. Areas requiring further research include costs associated with recruitment and implementation, adoption rate, and representativeness of participants and settings. This review adds data to support recommendations that interventions promoting PA in youth should include assessment of adoption and implementation issues. Copyright © 2015. Published by Elsevier Inc.
    No preview · Article · Apr 2015 · Preventive Medicine
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    • "Un-weighted sum totals were calculated for each study. Based on a dichotomy used in recent reviews [27,28] studies were classified as having a low (score ≥ 6) or high risk of bias (score ≤ 5). Two authors (EA and RC) assessed the risk of bias in the individual studies that met the inclusion criteria. "
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    ABSTRACT: Current recommendations for the prevention of type 2 diabetes advise modification of diet and exercise behaviors including both aerobic and resistance training. However, the efficacy of multi-component interventions involving a combination of these three components has not been established. The aims of this review were to systematically review and meta-analyze the evidence on multi-component (diet + aerobic exercise + resistance training) lifestyle interventions for type 2 diabetes prevention. Eight electronic databases (Medline, Embase, SportDiscus, Web of Science, CINAHL, Informit health collection, Cochrane library and Scopus) were searched up to June 2013. Eligible studies 1) recruited prediabetic adults or individuals at risk of type 2 diabetes; 2) conducted diet and exercise [including both physical activity/aerobic and resistance training] programs; and 3) reported weight and plasma glucose outcomes. In total, 23 articles from eight studies were eligible including five randomized controlled trials, one quasi-experimental, one two-group comparison and one single-group pre-post study. Four studies had a low risk of bias (score >= 6/10). Median intervention length was 12 months (range 4-48 months) with a follow-up of 18 months (range 6.5 - 48 months). The diet and exercise interventions varied slightly in terms of their specific prescriptions. Meta-analysis favored interventions over controls for weight loss (-3.79 kg [-6.13, -1.46; 95% CI], Z = 3.19, P = 0.001) and fasting plasma glucose (-0.13 mmol.L-1 [-0.24, -0.02; 95% CI], Z = 2.42, P = 0.02). Diabetes incidence was only reported in two studies, with reductions of 58% and 56% versus control groups. In summary, multi-component lifestyle type 2 diabetes prevention interventions that include diet and both aerobic and resistance exercise training are modestly effective in inducing weight loss and improving impaired fasting glucose, glucose tolerance, dietary and exercise outcomes in at risk and prediabetic adult populations. These results support the current exercise guidelines for the inclusion of resistance training in type 2 diabetes prevention, however there remains a need for more rigorous studies, with long-term follow-up evaluating program efficacy, muscular fitness outcomes, diabetes incidence and risk reduction.
    Full-text · Article · Jan 2014 · International Journal of Behavioral Nutrition and Physical Activity
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    • "Our results indicate that most of these adolescents (94.1%) want to do more types of activity. Despite this apparent willingness to increase physical activity, most physical activity promotion strategies are not effective [12,24,43,44]. Although an adolescent may say that they would like to try, or do more of a certain activity, it may not mean that they would take an opportunity if it was presented to them. "
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    ABSTRACT: Few large studies have examined adolescents' views about increasing their physical activity (PA) to inform PA promotion. We assessed adolescent preference for activity type, co-participants, timing and location of PA promotion and examined patterns in their views by population subgroup. Participants (n = 457) (Mean +/- SD age: 14.3 +/- 0.3 years; 45.2% male) responded to questionnaire items: "What activities would you like to try or do more often?" (yes/no to 6 activity types e.g. team sports) and "I would like to do more PA ..." followed by options regarding co-participants, timing and PA location (agree/disagree to 10 items). Anthropometry, demographics, accelerometer- and questionnaire-derived PA were obtained. Logistic regression was used to examine differences in views by subgroup (sex, weight status, objective PA level, parental education (SES)). Most adolescents wanted to increase participation in >=1 type of PA (94.4%). Gym use (56.7%) and team sports (50.6%) were most popular. Girls were less likely to choose racquet sports (vs. boys OR;95%CI 0.6;0.4-0.9) but more likely to select dancing (40.3;17.8-91.1). Preference for participation was positively associated with existing participation in a similar activity (all p < 0.02). More adolescents wanted to increase PA with friends (88.8%) than family (63.5%). A leisure centre was most popular for increased participation (81.0%), followed by home (70.0%). Participation during school time was less popular among girls (vs. boys: 0.6;0.4-0.9) and more popular among low SES participants (vs. high: 1.6;1.1-2.4). Overweight/obese adolescents were less likely to choose participation with friends (vs. normal weight 0.5;0.3-0.9). Targeting adolescent PA promotion by subgroup and providing choice of PA type, co-participants, timing and PA location appears promising. Adolescents want to do more types of PA more often; interventions could increase opportunities and support to facilitate this.
    Full-text · Article · Aug 2013 · BMC Public Health
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