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Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial
BACKGROUND: Evidence from a limited number of short-term trials indicates the difficulty in achieving population-level improvements in physical activity (PA) through community-wide interventions (CWIs). We sought to evaluate the effectiveness of a 5-year CWI for promoting PA in middle-aged and older...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913653/ https://www.ncbi.nlm.nih.gov/pubmed/29228255 http://dx.doi.org/10.1093/ije/dyx248 |
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author | Kamada, Masamitsu Kitayuguchi, Jun Abe, Takafumi Taguri, Masataka Inoue, Shigeru Ishikawa, Yoshiki Bauman, Adrian Lee, I-Min Miyachi, Motohiko Kawachi, Ichiro |
author_facet | Kamada, Masamitsu Kitayuguchi, Jun Abe, Takafumi Taguri, Masataka Inoue, Shigeru Ishikawa, Yoshiki Bauman, Adrian Lee, I-Min Miyachi, Motohiko Kawachi, Ichiro |
author_sort | Kamada, Masamitsu |
collection | PubMed |
description | BACKGROUND: Evidence from a limited number of short-term trials indicates the difficulty in achieving population-level improvements in physical activity (PA) through community-wide interventions (CWIs). We sought to evaluate the effectiveness of a 5-year CWI for promoting PA in middle-aged and older adults using a cluster randomized design. METHODS: We randomized 12 communities in Unnan, Japan, to either intervention (9) or control (3). Additionally, intervention communities were randomly allocated to three subgroups by different PA types promoted. Randomly sampled residents aged 40–79 years responded to the baseline survey (n = 4414; 74%) and were followed at 1, 3 and 5 years (78–83% response rate). The intervention was a 5-year CWI using social marketing to promote PA. The primary outcome was a change in recommended levels of PA. RESULTS: Compared with control communities, adults achieving recommended levels of PA increased in intervention communities [adjusted change difference = 4.6 percentage points (95% confidence interval: 0.4, 8.8)]. The intervention was effective for promoting all types of recommended PAs, i.e. aerobic (walking, 6.4%), flexibility (6.1%) and muscle-strengthening activities (5.7%). However, a bundled approach, which attempted to promote all forms of PAs above simultaneously, was not effective (1.3–3.4%, P ≥ 0.138). Linear dose–response relationships between the CWI awareness and changes in PA were observed (P ≤ 0.02). Pain intensity decreased in shoulder (intervention and control) and lower back (intervention only) but there was little change difference in all musculoskeletal pain outcomes between the groups. CONCLUSIONS: The 5-year CWI using the focused social marketing strategy increased the population-level of PA. |
format | Online Article Text |
id | pubmed-5913653 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-59136532018-04-30 Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial Kamada, Masamitsu Kitayuguchi, Jun Abe, Takafumi Taguri, Masataka Inoue, Shigeru Ishikawa, Yoshiki Bauman, Adrian Lee, I-Min Miyachi, Motohiko Kawachi, Ichiro Int J Epidemiol Miscellaneous BACKGROUND: Evidence from a limited number of short-term trials indicates the difficulty in achieving population-level improvements in physical activity (PA) through community-wide interventions (CWIs). We sought to evaluate the effectiveness of a 5-year CWI for promoting PA in middle-aged and older adults using a cluster randomized design. METHODS: We randomized 12 communities in Unnan, Japan, to either intervention (9) or control (3). Additionally, intervention communities were randomly allocated to three subgroups by different PA types promoted. Randomly sampled residents aged 40–79 years responded to the baseline survey (n = 4414; 74%) and were followed at 1, 3 and 5 years (78–83% response rate). The intervention was a 5-year CWI using social marketing to promote PA. The primary outcome was a change in recommended levels of PA. RESULTS: Compared with control communities, adults achieving recommended levels of PA increased in intervention communities [adjusted change difference = 4.6 percentage points (95% confidence interval: 0.4, 8.8)]. The intervention was effective for promoting all types of recommended PAs, i.e. aerobic (walking, 6.4%), flexibility (6.1%) and muscle-strengthening activities (5.7%). However, a bundled approach, which attempted to promote all forms of PAs above simultaneously, was not effective (1.3–3.4%, P ≥ 0.138). Linear dose–response relationships between the CWI awareness and changes in PA were observed (P ≤ 0.02). Pain intensity decreased in shoulder (intervention and control) and lower back (intervention only) but there was little change difference in all musculoskeletal pain outcomes between the groups. CONCLUSIONS: The 5-year CWI using the focused social marketing strategy increased the population-level of PA. Oxford University Press 2018-04 2017-12-07 /pmc/articles/PMC5913653/ /pubmed/29228255 http://dx.doi.org/10.1093/ije/dyx248 Text en © The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Miscellaneous Kamada, Masamitsu Kitayuguchi, Jun Abe, Takafumi Taguri, Masataka Inoue, Shigeru Ishikawa, Yoshiki Bauman, Adrian Lee, I-Min Miyachi, Motohiko Kawachi, Ichiro Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial |
title | Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial |
title_full | Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial |
title_fullStr | Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial |
title_full_unstemmed | Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial |
title_short | Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial |
title_sort | community-wide intervention and population-level physical activity: a 5-year cluster randomized trial |
topic | Miscellaneous |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913653/ https://www.ncbi.nlm.nih.gov/pubmed/29228255 http://dx.doi.org/10.1093/ije/dyx248 |
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