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The Effectiveness of Interventions on Sustained Childhood Physical Activity: A Systematic Review and Meta-Analysis of Controlled Studies.

Sims J, Scarborough P, Foster C - PLoS ONE (2015)

Bottom Line: Increased physical activity (PA) has been associated with a reduction in non-communicable disease risk factors and outcomes.Meta-regression revealed no significant differences by factor on pooled effects.Significant heterogeneity existed between studies and potential for small study effects was present.

View Article: PubMed Central - PubMed

Affiliation: The British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Department of Sport Development and Management, University of Chichester, Chichester, United Kingdom.

ABSTRACT

Background: Increased physical activity (PA) has been associated with a reduction in non-communicable disease risk factors and outcomes. However, interventions to increase childhood PA typically produce small to negligible effects. Recent reviews are limited due to lack of post-intervention follow-up measurement. This review aimed to examine measured effects at least six months post-intervention.

Methods and findings: We searched PubMed, MEDLINE, EMBASE, PsychINFO, ScienceDirect, SportDiscus and Google Scholar between 1st January 1991 and 1st November 2014 for controlled studies reporting six-month post-intervention measurement for children aged 5 to 18 years. 14 studies met inclusion criteria; 12 reported moderate-to-vigorous PA (MVPA) (n = 5790) and 10 reported total PA (TPA) (n = 4855). We calculated overall effect estimates and 95% CI's using random effects modelling with inverse variance weighting. Mean difference was calculated for MVPA, with standardised mean difference calculated to TPA due to measurement variation. Meta-regression assessed heterogeneity by continuous level variables. Negligible mean difference in MVPA existed in favour of the intervention group, amounting to 1.47 (95% CI -1.88, 4.82) mins/day compared to controls, while no difference was recorded on TPA. Sub-group analyses revealed males (2.65 mins/day: 95% CI 2.03, 3.27) reported higher levels of MVPA than females (-0.42 mins/day: 95% CI -7.77, 6.94), community settings (2.67 mins/day: 95% CI 2.05, 3.28) were more effective than school settings (1.70 mins/day: 95% CI -4.84, 8.25), and that treatment (4.47 mins/day: 95% CI -0.81, 9.76) demonstrated greater effects than population approaches (1.03 mins/day: 95% CI -2.54, 4.60). Meta-regression revealed no significant differences by factor on pooled effects. Significant heterogeneity existed between studies and potential for small study effects was present.

Conclusions: Improved PA levels subsequent to intervention were not maintained six month post-intervention. A potentially useful avenue of future research is to specifically explore community treatment of high risk individuals.

Review registration: PROSPERO CRD42014007545.

No MeSH data available.


PRISMA Flow Chart Summarising the Study Selection Process.
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pone.0132935.g001: PRISMA Flow Chart Summarising the Study Selection Process.

Mentions: The searches were conducted and completed in February 2014. The initial search of databases resulted in 15,696 identified studies, with 13 additional studies identified from relevant systematic reviews. Removal of duplicates and analysis of titles then allowed unambiguously ineligible studies to be excluded, leaving a sub-total of 1,493. Scrutiny of abstracts of the remaining studies revealed 138 potentially relevant studies. Full text articles were then reviewed, producing a total of 18 preliminarily studies. Four further studies were excluded at the data extraction stage, leaving 14 studies for the final systematic review. A PRISMA flow-chart [55] of the study selection process is provided in Fig 1.


The Effectiveness of Interventions on Sustained Childhood Physical Activity: A Systematic Review and Meta-Analysis of Controlled Studies.

Sims J, Scarborough P, Foster C - PLoS ONE (2015)

PRISMA Flow Chart Summarising the Study Selection Process.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4507864&req=5

pone.0132935.g001: PRISMA Flow Chart Summarising the Study Selection Process.
Mentions: The searches were conducted and completed in February 2014. The initial search of databases resulted in 15,696 identified studies, with 13 additional studies identified from relevant systematic reviews. Removal of duplicates and analysis of titles then allowed unambiguously ineligible studies to be excluded, leaving a sub-total of 1,493. Scrutiny of abstracts of the remaining studies revealed 138 potentially relevant studies. Full text articles were then reviewed, producing a total of 18 preliminarily studies. Four further studies were excluded at the data extraction stage, leaving 14 studies for the final systematic review. A PRISMA flow-chart [55] of the study selection process is provided in Fig 1.

Bottom Line: Increased physical activity (PA) has been associated with a reduction in non-communicable disease risk factors and outcomes.Meta-regression revealed no significant differences by factor on pooled effects.Significant heterogeneity existed between studies and potential for small study effects was present.

View Article: PubMed Central - PubMed

Affiliation: The British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Department of Sport Development and Management, University of Chichester, Chichester, United Kingdom.

ABSTRACT

Background: Increased physical activity (PA) has been associated with a reduction in non-communicable disease risk factors and outcomes. However, interventions to increase childhood PA typically produce small to negligible effects. Recent reviews are limited due to lack of post-intervention follow-up measurement. This review aimed to examine measured effects at least six months post-intervention.

Methods and findings: We searched PubMed, MEDLINE, EMBASE, PsychINFO, ScienceDirect, SportDiscus and Google Scholar between 1st January 1991 and 1st November 2014 for controlled studies reporting six-month post-intervention measurement for children aged 5 to 18 years. 14 studies met inclusion criteria; 12 reported moderate-to-vigorous PA (MVPA) (n = 5790) and 10 reported total PA (TPA) (n = 4855). We calculated overall effect estimates and 95% CI's using random effects modelling with inverse variance weighting. Mean difference was calculated for MVPA, with standardised mean difference calculated to TPA due to measurement variation. Meta-regression assessed heterogeneity by continuous level variables. Negligible mean difference in MVPA existed in favour of the intervention group, amounting to 1.47 (95% CI -1.88, 4.82) mins/day compared to controls, while no difference was recorded on TPA. Sub-group analyses revealed males (2.65 mins/day: 95% CI 2.03, 3.27) reported higher levels of MVPA than females (-0.42 mins/day: 95% CI -7.77, 6.94), community settings (2.67 mins/day: 95% CI 2.05, 3.28) were more effective than school settings (1.70 mins/day: 95% CI -4.84, 8.25), and that treatment (4.47 mins/day: 95% CI -0.81, 9.76) demonstrated greater effects than population approaches (1.03 mins/day: 95% CI -2.54, 4.60). Meta-regression revealed no significant differences by factor on pooled effects. Significant heterogeneity existed between studies and potential for small study effects was present.

Conclusions: Improved PA levels subsequent to intervention were not maintained six month post-intervention. A potentially useful avenue of future research is to specifically explore community treatment of high risk individuals.

Review registration: PROSPERO CRD42014007545.

No MeSH data available.