Theory-based behavioral intervention increases self-reported physical activity in South African men: A cluster-randomized controlled trial

Abstract

Objective To determine whether a health-promotion intervention increases South African men’s adherence to physical-activity guidelines. Method We utilized a cluster-randomized controlled trial design. Eligible clusters, residential neighborhoods near East London, South Africa, were matched in pairs. Within randomly selected pairs, neighborhoods were randomized to theory-based, culturally congruent health-promotion intervention encouraging physical activity or attention-matched HIV/STI risk-reduction control intervention. Men residing in the neighborhoods and reporting coitus in the previous 3 months were eligible. Primary outcome was self-reported individual-level adherence to physical-activity guidelines averaged over 6-month and 12-month post-intervention assessments. Data were collected in 2007–2010. Data collectors, but not facilitators or participants, were blind to group assignment. Results Primary outcome intention-to-treat analysis included 22 of 22 clusters and 537 of 572 men in the health-promotion intervention and 22 of 22 clusters and 569 of 609 men in the attention-control intervention. Model-estimated probability of meeting physical-activity guidelines was 51.0% in the health-promotion intervention and 44.7% in attention-matched control (OR = 1.34; 95% CI, 1.09–1.63), adjusting for baseline prevalence and clustering from 44 neighborhoods. Conclusion A theory-based culturally congruent intervention increased South African men’s self-reported physical activity, a key contributor to deaths from non-communicable diseases in South Africa. Trial registration ClinicalTrials.gov Identifier: NCT01490359.

Protective Factors and HIV Risk Behavior Among South African Men

“…As reported elsewhere, participants enrolled in the trial during a 25-month period beginning in November 2007. 35,36 We identified 206 neighborhoods defined as geographical clusters tied to census data in the catchment area and randomly selected 44 for the trial. Before recruiting from a neighborhood, research team members met with community leaders to enlist their support.…”

Prevalence and socio-demographic correlates of physical activity levels among South African adults in Cape Town and Mount Frere communities in 2008-2009

“…In South Africa, 3.3% of all deaths in 2000 were attributable to PA, ranking it 9 th among other risk factors [6]. The prevalence of self-reported physical inactivity is high in both developed countries like the United States, where 32% of adults are physically inactive [7], and in developing countries such as South Africa were 45% adults were reported to be inactive [8]. Other African countries also report a high prevalence of physical inactivity among adults, 49.1% and 52.6% in Swaziland and Mauritania respectively [8].…”

Mediation of effects of a theory-based behavioral intervention on self-reported physical activity in South African men

“…The health-promotion intervention was developed based on the theory of planned behavior (Ajzen, 1991; Armitage and Conner, 2001; Hagger et al, 2002; McEachan et al, 2011), a theory selected for its ease of adaptation to different cultures and behaviors (Jemmott, 2012) and its utility in efficacious interventions (Darker et al, 2010; Montanaro and Bryan, 2014; Plotnikoff et al, 2014; Zhang et al, 2009), including interventions in South Africa (Heeren et al, 2013; Jemmott et al, 2011; Jemmott et al, 2014c). The health-promotion intervention significantly increased self-reported adherence to physical-activity guidelines averaged over the 6- and 12-month post-intervention assessments, which was the primary outcome, compared with the attention-control group (Jemmott et al, 2014a). …”