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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...

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Autores principales: Kamada, Masamitsu, Kitayuguchi, Jun, Abe, Takafumi, Taguri, Masataka, Inoue, Shigeru, Ishikawa, Yoshiki, Bauman, Adrian, Lee, I-Min, Miyachi, Motohiko, Kawachi, Ichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
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.
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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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