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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.


Overall Assessed Risk of Bias within the 14 Included Studies.
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pone.0132935.g002: Overall Assessed Risk of Bias within the 14 Included Studies.

Mentions: Quality was assessed using the Methodology Checklist for Randomised Controlled Trials [57]. Overall there was a high number of ‘uncertain’ verdicts against the papers, potentially indicating the reporting of relevant information within the published articles was more pertinent than the actual methodological quality of the studies (Fig 2). Participants lost to follow-up ranged from 0% to 50%, with studies reporting analyses of attrition characteristics. Eight of the nine studies utilising cluster-randomised design reported appropriate statistical techniques by which to account for clustering within the aggregate outcomes. A visual inspection of funnel plots for both outcomes suggested the possibility of small-study effect (Fig 3).


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)

Overall Assessed Risk of Bias within the 14 Included Studies.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0132935.g002: Overall Assessed Risk of Bias within the 14 Included Studies.
Mentions: Quality was assessed using the Methodology Checklist for Randomised Controlled Trials [57]. Overall there was a high number of ‘uncertain’ verdicts against the papers, potentially indicating the reporting of relevant information within the published articles was more pertinent than the actual methodological quality of the studies (Fig 2). Participants lost to follow-up ranged from 0% to 50%, with studies reporting analyses of attrition characteristics. Eight of the nine studies utilising cluster-randomised design reported appropriate statistical techniques by which to account for clustering within the aggregate outcomes. A visual inspection of funnel plots for both outcomes suggested the possibility of small-study effect (Fig 3).

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.