Community wide interventions for increasing physical activity

Baker, Philip; Francis, Daniel; Soares, Jesus; Weightman, Alison Lesley; Foster, Charlie

doi:10.1002/14651858.cd008366.pub2

Cited by 99 publications

(98 citation statements)

References 201 publications

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“…393 Neither is there any consistent evidence to support the hypothesis that multicomponent community-wide interventions are effective at increasing levels of physical activity. 394 The third review found that professional advice with ongoing support has only a moderate effect on increasing self-reported physical activity in the short to mid-term. 392 However, in the studies for this review most participants were volunteers, limiting its applicability to a general practice population.…”

Section: Effectiveness Of Health Improvement Activities Undertaken Inmentioning

confidence: 99%

“…There have been three relevant Cochrane reviews [392][393][394] that directly examined evidence for general exercise and weight loss interventions. In addition, there were a number of reviews that specifically addressed diet, exercise and weight loss for the prevention of specific conditions including diabetes [395][396][397] and CVD.…”

Section: Effectiveness Of Health Improvement Activities Undertaken Inmentioning

confidence: 99%

“…As discussed earlier in this chapter, Cochrane reviews of community interventions for exercise and weight loss, and for smoking found little robust evidence of positive effect on smoking prevalence or sustained weight loss. 394,414 The studies also either said little about who delivered the interventions or found little difference in who delivered interventions or how they were organised.…”

Section: Community-based Approachesmentioning

confidence: 99%

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The organisation and delivery of health improvement in general practice and primary care: a scoping study

Peckham

Falconer

Gillam

et al. 2015

Health Serv Deliv Res

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BackgroundThis project examines the organisation and delivery of health improvement activities by and within general practice and the primary health-care team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices, how individual practices and the primary health-care team organise such public health activities, and how these contribute to health improvement. Our focus was on health promotion and ill-health prevention activities.AimsThe aim of this scoping exercise was to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary health-care team. The key objectives were to provide an overview of the range and type of health improvement activities, identify gaps in knowledge and areas for further empirical research. Our specific research objectives were to map the range and type of health improvement activity undertaken by general practice staff and the primary health-care team based within general practice; to scope the literature on health improvement in general practice or undertaken by health-care staff based in general practice and identify gaps in the evidence base; to synthesise the literature and identify effective approaches to the delivery and organisation of health improvement interventions in a general practice setting; and to identify the priority areas for research as defined by those working in general practice.MethodsWe undertook a comprehensive search of the literature. We followed a staged selection process involving reviews of titles and abstracts. This resulted in the identification of 1140 papers for data extraction, with 658 of these papers selected for inclusion in the review, of which 347 were included in the evidence synthesis. We also undertook 45 individual and two group interviews with primary health-care staff.FindingsMany of the research studies reviewed had some details about the type, process or location, or who provided the intervention. Generally, however, little attention is paid in the literature to examining the impact of the organisational context on the way services are delivered or how this affects the effectiveness of health improvement interventions in general practice. We found that the focus of attention is mainly on individual prevention approaches, with practices engaging in both primary and secondary prevention. The range of activities suggests that general practitioners do not take a population approach but focus on individual patients. However, it is clear that many general practitioners see health promotion as an integral part of practice, whether as individual approaches to primary or secondary health improvement or as a practice-based approach to improving the health of their patients. Our key conclusion is that there is currently insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care more widely.Future ResearchFuture research on health improvement in general practice and by the primary health-care team needs to move beyond clinical research to include delivery systems and be conducted in a primary care setting. More research needs to examine areas where there are chronic disease burdens – cancer, dementia and other disabilities of old age. Reviews should be commissioned that examine the whole prevention pathway for health problems that are managed within primary care drawing together research from general practice, pharmacy, community engagement, etc.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Effectiveness Of Health Improvement Activities Undertaken Inmentioning

confidence: 99%

Section: Effectiveness Of Health Improvement Activities Undertaken Inmentioning

confidence: 99%

Section: Community-based Approachesmentioning

confidence: 99%

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The organisation and delivery of health improvement in general practice and primary care: a scoping study

Peckham

Falconer

Gillam

et al. 2015

Health Serv Deliv Res

View full text Add to dashboard Cite

show abstract

“…The authors identified 33 studies addressing 267 total communities that met criteria for inclusion in the review [1,5]. Almost all of the studies involved partnerships with local governments or non-government organizations (NGOs), but only four employed all six of the strategies that Baker and colleagues identified as characterizing an integrated community PA intervention.…”

Section: Resultsmentioning

confidence: 99%

Physical activity: a synopsis and comment on “community-wide interventions for increasing physical activity”

Hoffman

Warnick

Garza

et al. 2016

Behav. Med. Pract. Policy Res.

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In this synopsis, we summarize and comment on Baker and colleagues' Cochrane review of studies on the population-level impact of community-wide physical activity (PA) interventions. Insufficient PA remains a major public health problem. Community-wide interventions offer an opportunity to extend reach by increasing the proportion of the population experiencing the intervention. A previous Cochrane review of community-wide PA interventions concluded that evidence for effectiveness was mixed. Hence, Baker and colleagues incorporated new data about community-based PA interventions. This Cochrane review concluded there is an overall lack of evidence that community-wide interventions improve PA outcomes at the population level. Recommendations are that future research should use high quality research design, more explicitly test ways to increase reach, and utilize objective measurements of PA to increase validity. We suggest that future research should first optimize the intervention by systematically evaluating treatment components and selecting a maximally efficient and effective treatment package.

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“…Eleven studies were included, ten of which focused on adults, from which Cavill, Richardson and Foster (2012) concluded : (2003) reported on a home-based exercise and walking intervention with telephone support from an exercise specialist employed by a local sports foundation. Five studies showed no statistically significant increases in physical activity, and four were rated by a previous Cochrane review (Baker, Francis, Soares, Weightman & Foster, 2011) as having a high risk of bias. One in ten participants in the home-based exercise and walking intervention (Elley et al, 2003) increased their physical activity to over 150 minutes per week after 12 months, but this study was assessed low quality by a previous Cochrane review (Foster, Hillsdon, Thorogood, Kaur & Wedatilake, 2005), and that the exercise specialist was employed by a "sports foundation" did not provide a meaningful sport element.…”

Section: Contextmentioning

confidence: 93%

Should we privilege sport for health? The comparative effectiveness of UK Government investment in sport as a public health intervention

Weed

2016

International Journal of Sport Policy and Politics

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Community wide interventions for increasing physical activity

Cited by 99 publications

References 201 publications

The organisation and delivery of health improvement in general practice and primary care: a scoping study

The organisation and delivery of health improvement in general practice and primary care: a scoping study

Physical activity: a synopsis and comment on “community-wide interventions for increasing physical activity”

Should we privilege sport for health? The comparative effectiveness of UK Government investment in sport as a public health intervention

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