A systematic review of interventions to increase attendance at health and fitness venues: identifying key behaviour change techniques

BACKGROUND: Members’ attendance at health and fitness venues typically declines over the course of their membership, with a likely negative impact on physical activity and health outcomes. This systematic review sought to examine the effectiveness of interventions to increase attendance at health and fitness venues and identify the behaviour change techniques (BCTs) included in effective interventions. METHODS: A systematic search of seven databases was conducted. The Behaviour Change Technique Taxonomy was used to code the interventions. Cohen’s d was used to assess the effectiveness of the interventions. RESULTS: Fourteen papers reporting 20 interventions were included in the review. Most interventions were found to have trivial or small effects on attendance, although one had a medium effect (d = 0.60) and three had a large effect (ds = 1.00, 1.37, 1.45). The interventions used a limited range of BCTs, with “Prompts/Cues” being the most frequently used. Of the interventions with large effect sizes, two used “Problem solving” and “Pros and cons” and one used “Goal setting (behaviour)” and “Review behaviour goals”. CONCLUSIONS: Only a small number of studies have tested interventions to increase attendance at health and fitness venues, with predominantly trivial or small effects. With the possible exception of problem solving alongside decisional balance and goal setting alongside reviewing behaviour goals, there is little evidence for the effectiveness of specific BCTs. Further research is required to identify the key components of effective interventions to increase attendance at health and fitness venues.