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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.


Forest Plot Showing the Standardised Mean Difference in Change in TPA between Intervention (n = 2749) and Control (n = 2106).Groups across the 10 included studies reporting TPA data.
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pone.0132935.g005: Forest Plot Showing the Standardised Mean Difference in Change in TPA between Intervention (n = 2749) and Control (n = 2106).Groups across the 10 included studies reporting TPA data.

Mentions: The collated results from twelve included studies showed weak evidence for a small increase in MVPA in favour of the intervention group with a mean difference of 1.47 minutes per day (95% CI -1.88, 4.82; p = 0.39) (Fig 4). For the ten studies reporting TPA the analysis showed no difference between the pooled effects of the intervention and those for the control group, with a standardised mean difference of -0.13 (95% CI -0.74, 0.48; p = 0.67) (Fig 5). Of most successful studies Araujo-Soares et al. [50] reported a mean difference 59 mins/day (95% CI 21.44, 96.56; p = 0.002) of additional MVPA and Nemet et al. [42] reported a standardised mean difference of 0.82 (95% CI 0.18, 1.47, p = 0.01). I2 values of 98% for MVPA (p < 0.001) and TPA (p < 0.001) revealed high levels of statistical heterogeneity between studies within both outcomes and a consequential requirement for caution with interpreting the results.


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)

Forest Plot Showing the Standardised Mean Difference in Change in TPA between Intervention (n = 2749) and Control (n = 2106).Groups across the 10 included studies reporting TPA data.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0132935.g005: Forest Plot Showing the Standardised Mean Difference in Change in TPA between Intervention (n = 2749) and Control (n = 2106).Groups across the 10 included studies reporting TPA data.
Mentions: The collated results from twelve included studies showed weak evidence for a small increase in MVPA in favour of the intervention group with a mean difference of 1.47 minutes per day (95% CI -1.88, 4.82; p = 0.39) (Fig 4). For the ten studies reporting TPA the analysis showed no difference between the pooled effects of the intervention and those for the control group, with a standardised mean difference of -0.13 (95% CI -0.74, 0.48; p = 0.67) (Fig 5). Of most successful studies Araujo-Soares et al. [50] reported a mean difference 59 mins/day (95% CI 21.44, 96.56; p = 0.002) of additional MVPA and Nemet et al. [42] reported a standardised mean difference of 0.82 (95% CI 0.18, 1.47, p = 0.01). I2 values of 98% for MVPA (p < 0.001) and TPA (p < 0.001) revealed high levels of statistical heterogeneity between studies within both outcomes and a consequential requirement for caution with interpreting the results.

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.