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Physical Activity: Social Support Interventions in Community Settings

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What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 9 studies (search period 1980 – 2000).

The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to increasing physical activity.

Summary of Results

Detailed results from the systematic review are available in the published evidence review pdf icon [PDF - 3.14 MB].

Nine studies were included in the review.

  • All studies found interventions were effective in getting people to be more physically active, as measured by various indicators (e.g., blocks walked or flights of stairs climbed daily, frequency of attending exercise sessions, or minutes spent in physical activity).
    • Time spent being physically active: median increase of 44.2% (5 study arms)
    • Frequency of physical activity: median increase of 19.6% (6 study arms)
    • Aerobic capacity: median net increase in of 4.7% (5 study arms)
  • One study found that those who received more frequent support were more active than those who received less frequent support, although both highly structured and less formal support were equally effective.
  • Interventions improved participants’ fitness levels, lowered their percentage of body fat, increased their knowledge about exercise, and improved their confidence in their ability to exercise.

Summary of Economic Evidence

An economic review of this intervention did not find any relevant studies.

Applicability

Results should be applicable to diverse settings and populations provided interventions are adapted to target populations.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

  • What type of social support and which media work for which people?
  • Do intensity and structure of the support make a difference?
  • How does effect size vary by how often people interact?
  • What are the effects of each intervention in various sociodemographic subgroups, such as age, gender, race, or ethnicity?
  • Do informational approaches to increasing physical activity increase health knowledge? To increase physical activity levels, are increased knowledge or improved attitudes toward physical activity needed?
  • Do these approaches to increasing physical activity increase awareness of opportunities for, and benefits of, physical activity?
  • After the initial behavior change, what are the most effective ways to maintain physical activity levels?
  • Are there other benefits from an intervention that might enhance its acceptability? For example, is increasing social support for physical activity reflected in an overall greater sense of community?
  • Are there any key harms?
  • Is anything known about whether or how approaches to physical activity could reduce potential harms (e.g., injuries or other problems associated with doing too much too fast)?
  • Can reliable and valid measures be developed to address the entire spectrum of physical activity, including light or moderate activity?
  • Are these interventions cost effective?
  • How can effectiveness in terms of health outcomes or quality-adjusted health outcomes be better measured, estimated, or modeled?
  • How can the cost–benefit of these programs be estimated?
  • How do specific characteristics of these interventions contribute to economic efficiency?
  • What combinations of components in multicomponent interventions are most cost-effective?
  • What are the physical or structural (environmental) barriers to implementing these interventions?
  • What resource (time and money) constraints slow or stop the implementation of these interventions?

Study Characteristics

  • In most studies, volunteers were grouped to provide companionship and support to help each other reach self-selected activity goals. Participants received phone calls from each other and from study staff to monitor progress and encourage continued activity.
  • Some studies involved formal discussion groups to address barriers to exercise and negative perceptions about activity.
  • Studies were conducted in the United States (7 studies), Canada (1 study), and Australia (1 study).
  • Studies were offered in community settings, including community centers and churches (6 studies), a worksite (1 study), and a university (2 studies).
  • Six studies exclusively or primarily reported results for women; three studies included men and women.
  • Study populations for most studies were middle-aged; one study included women aged 18 years or older, and one study focused on women aged 50 to 65 years.
  • Three studies restricted their populations to people who were sedentary at the beginning of the study; the rest included people at any initial level of activity.

Publications

Kahn EB, Ramsey LT, Brownson RC, et al. The effectiveness of interventions to increase physical activity: a systematic review. American Journal of Preventive Medicine. 2002;22(4S):73-107.
Task Force on Community Services. Recommendations to increase physical activity in communities. American Journal of Preventive Medicine. 2002;22(4S):67-72.
Centers for Disease Control and Prevention. Increasing physical activity. A report on recommendations of the Task Force on Community Preventive Services. MMWR. 2001;50(RR-18):1-16. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5018a1.htm.
Dunn AL, Blair SN. Translating evidence-based physical activity interventions into practice. American Journal of Preventive Medicine. 2002;22(4S):8-9.
Task Force on Community Services, Zaza S, Briss PA, Harris KW. Physical activity. In: The Guide to Community Preventive Services: What Works to Promote Health?. The Guide to Community Preventive Services: What Works to Promote Health? Atlanta (GA): Oxford University Press; 2005:80-113.

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