Are physical activity interventions for healthy inactive adults effective in promoting behavior change and maintenance, and which behavior change techniques are effective? A systematic review and meta-analysis
Physical inactivity and sedentary behavior relate to poor health outcomes independently. Healthy inactive adults are a key target population for prevention. This systematic review and meta-analysis aimed to evaluate the effectiveness of physical activity and/or sedentary behavior interventions, meas...
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| Published in: | Translational behavioral medicine Vol. 9; no. 1; pp. 147 - 157 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Oxford University Press
01.02.2019
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| Subjects: | |
| ISSN: | 1869-6716, 1613-9860, 1613-9860 |
| Online Access: | Get full text |
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| Abstract | Physical inactivity and sedentary behavior relate to poor health outcomes independently. Healthy inactive adults are a key target population for prevention. This systematic review and meta-analysis aimed to evaluate the effectiveness of physical activity and/or sedentary behavior interventions, measured postintervention (behavior change) and at follow-up (behavior change maintenance), to identify behavior change techniques (BCT) within, and report on fidelity. Included studies were randomized controlled trials, targeting healthy inactive adults, aiming to change physical activity and/or sedentary behavior, with a minimum postintervention follow-up of 6 months, using 16 databases from 1990. Two reviewers independently coded risk of bias, the "Template for Intervention Description and Replication" (TIDieR) checklist, and BCTs. Twenty-six studies were included; 16 pooled for meta-analysis. Physical activity interventions were effective at changing behavior (d = 0.32, 95% confidence intervals = 0.16-0.48, n = 2,346) and maintaining behavior change after 6 months or more (d = 0.21, 95% confidence intervals = 0.12-0.30, n = 2,190). Sedentary behavior interventions (n = 2) were not effective. At postintervention, physical activity intervention effectiveness was associated with the BCTs "Biofeedback," "Demonstration of the behavior," "Behavior practice/rehearsal," and "Graded tasks." At follow-up, effectiveness was associated with using "Action planning," "Instruction on how to perform the behavior," "Prompts/cues," "Behavior practice/rehearsal," "Graded tasks," and "Self-reward." Fidelity was only documented in one study. Good evidence was found for behavior change maintenance effects in healthy inactive adults, and underlying BCTs. This review provides translational evidence to improve research, intervention design, and service delivery in physical activity interventions, while highlighting the lack of fidelity measurement. |
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| AbstractList | Physical inactivity and sedentary behavior relate to poor health outcomes independently. Healthy inactive adults are a key target population for prevention. This systematic review and meta-analysis aimed to evaluate the effectiveness of physical activity and/or sedentary behavior interventions, measured postintervention (behavior change) and at follow-up (behavior change maintenance), to identify behavior change techniques (BCT) within, and report on fidelity. Included studies were randomized controlled trials, targeting healthy inactive adults, aiming to change physical activity and/or sedentary behavior, with a minimum postintervention follow-up of 6 months, using 16 databases from 1990. Two reviewers independently coded risk of bias, the “Template for Intervention Description and Replication” (TIDieR) checklist, and BCTs. Twenty-six studies were included; 16 pooled for meta-analysis. Physical activity interventions were effective at changing behavior (d = 0.32, 95% confidence intervals = 0.16–0.48, n = 2,346) and maintaining behavior change after 6 months or more (d = 0.21, 95% confidence intervals = 0.12–0.30, n = 2,190). Sedentary behavior interventions (n = 2) were not effective. At postintervention, physical activity intervention effectiveness was associated with the BCTs “Biofeedback,” “Demonstration of the behavior,” “Behavior practice/rehearsal,” and “Graded tasks.” At follow-up, effectiveness was associated with using “Action planning,” “Instruction on how to perform the behavior,” “Prompts/cues,” “Behavior practice/rehearsal,” “Graded tasks,” and “Self-reward.” Fidelity was only documented in one study. Good evidence was found for behavior change maintenance effects in healthy inactive adults, and underlying BCTs. This review provides translational evidence to improve research, intervention design, and service delivery in physical activity interventions, while highlighting the lack of fidelity measurement. Interventions in healthy adults who struggle to regularly exercise are effective in improving physical activity levels and maintaining this change at least 6 months later. Effective techniques include practicing to increase skill and gradually increasing the intensity of exercises.' Physical inactivity and sedentary behavior relate to poor health outcomes independently. Healthy inactive adults are a key target population for prevention. This systematic review and meta-analysis aimed to evaluate the effectiveness of physical activity and/or sedentary behavior interventions, measured postintervention (behavior change) and at follow-up (behavior change maintenance), to identify behavior change techniques (BCT) within, and report on fidelity. Included studies were randomized controlled trials, targeting healthy inactive adults, aiming to change physical activity and/or sedentary behavior, with a minimum postintervention follow-up of 6 months, using 16 databases from 1990. Two reviewers independently coded risk of bias, the “Template for Intervention Description and Replication” (TIDieR) checklist, and BCTs. Twenty-six studies were included; 16 pooled for meta-analysis. Physical activity interventions were effective at changing behavior (d = 0.32, 95% confidence intervals = 0.16–0.48, n = 2,346) and maintaining behavior change after 6 months or more (d = 0.21, 95% confidence intervals = 0.12–0.30, n = 2,190). Sedentary behavior interventions (n = 2) were not effective. At postintervention, physical activity intervention effectiveness was associated with the BCTs “Biofeedback,” “Demonstration of the behavior,” “Behavior practice/rehearsal,” and “Graded tasks.” At follow-up, effectiveness was associated with using “Action planning,” “Instruction on how to perform the behavior,” “Prompts/cues,” “Behavior practice/rehearsal,” “Graded tasks,” and “Self-reward.” Fidelity was only documented in one study. Good evidence was found for behavior change maintenance effects in healthy inactive adults, and underlying BCTs. This review provides translational evidence to improve research, intervention design, and service delivery in physical activity interventions, while highlighting the lack of fidelity measurement. Physical inactivity and sedentary behavior relate to poor health outcomes independently. Healthy inactive adults are a key target population for prevention. This systematic review and meta-analysis aimed to evaluate the effectiveness of physical activity and/or sedentary behavior interventions, measured postintervention (behavior change) and at follow-up (behavior change maintenance), to identify behavior change techniques (BCT) within, and report on fidelity. Included studies were randomized controlled trials, targeting healthy inactive adults, aiming to change physical activity and/or sedentary behavior, with a minimum postintervention follow-up of 6 months, using 16 databases from 1990. Two reviewers independently coded risk of bias, the "Template for Intervention Description and Replication" (TIDieR) checklist, and BCTs. Twenty-six studies were included; 16 pooled for meta-analysis. Physical activity interventions were effective at changing behavior (d= 0.32, 95% confidence intervals = 0.16-0.48, n= 2,346) and maintaining behavior change after 6 months or more (d=0.21, 95% confidence intervals = 0.12-0.30, n= 2,190). Sedentary behavior interventions (n = 2) were not effective. At postintervention, physical activity intervention effectiveness was associated with the BCTs "Biofeedback," "Demonstration of the behavior," "Behavior practice/rehearsal," and "Graded tasks." At follow-up, effectiveness was associated with using "Action planning," "Instruction on how to perform the behavior," "Prompts/cues," "Behavior practice/rehearsal," "Graded tasks," and "Self-reward." Fidelity was only documented in one study. Good evidence was found for behavior change maintenance effects in healthy inactive adults, and underlying BCTs. This review provides translational evidence to improve research, intervention design, and service delivery in physical activity interventions, while highlighting the lack of fidelity measurement. Keywords Inactive lifestyle, Physical activity, Behavior change, Systematic review, Behavior change techniques, Behavior change maintenance Physical inactivity and sedentary behavior relate to poor health outcomes independently. Healthy inactive adults are a key target population for prevention. This systematic review and meta-analysis aimed to evaluate the effectiveness of physical activity and/or sedentary behavior interventions, measured postintervention (behavior change) and at follow-up (behavior change maintenance), to identify behavior change techniques (BCT) within, and report on fidelity. Included studies were randomized controlled trials, targeting healthy inactive adults, aiming to change physical activity and/or sedentary behavior, with a minimum postintervention follow-up of 6 months, using 16 databases from 1990. Two reviewers independently coded risk of bias, the "Template for Intervention Description and Replication" (TIDieR) checklist, and BCTs. Twenty-six studies were included; 16 pooled for meta-analysis. Physical activity interventions were effective at changing behavior (d = 0.32, 95% confidence intervals = 0.16-0.48, n = 2,346) and maintaining behavior change after 6 months or more (d = 0.21, 95% confidence intervals = 0.12-0.30, n = 2,190). Sedentary behavior interventions (n = 2) were not effective. At postintervention, physical activity intervention effectiveness was associated with the BCTs "Biofeedback," "Demonstration of the behavior," "Behavior practice/rehearsal," and "Graded tasks." At follow-up, effectiveness was associated with using "Action planning," "Instruction on how to perform the behavior," "Prompts/cues," "Behavior practice/rehearsal," "Graded tasks," and "Self-reward." Fidelity was only documented in one study. Good evidence was found for behavior change maintenance effects in healthy inactive adults, and underlying BCTs. This review provides translational evidence to improve research, intervention design, and service delivery in physical activity interventions, while highlighting the lack of fidelity measurement.Physical inactivity and sedentary behavior relate to poor health outcomes independently. Healthy inactive adults are a key target population for prevention. This systematic review and meta-analysis aimed to evaluate the effectiveness of physical activity and/or sedentary behavior interventions, measured postintervention (behavior change) and at follow-up (behavior change maintenance), to identify behavior change techniques (BCT) within, and report on fidelity. Included studies were randomized controlled trials, targeting healthy inactive adults, aiming to change physical activity and/or sedentary behavior, with a minimum postintervention follow-up of 6 months, using 16 databases from 1990. Two reviewers independently coded risk of bias, the "Template for Intervention Description and Replication" (TIDieR) checklist, and BCTs. Twenty-six studies were included; 16 pooled for meta-analysis. Physical activity interventions were effective at changing behavior (d = 0.32, 95% confidence intervals = 0.16-0.48, n = 2,346) and maintaining behavior change after 6 months or more (d = 0.21, 95% confidence intervals = 0.12-0.30, n = 2,190). Sedentary behavior interventions (n = 2) were not effective. At postintervention, physical activity intervention effectiveness was associated with the BCTs "Biofeedback," "Demonstration of the behavior," "Behavior practice/rehearsal," and "Graded tasks." At follow-up, effectiveness was associated with using "Action planning," "Instruction on how to perform the behavior," "Prompts/cues," "Behavior practice/rehearsal," "Graded tasks," and "Self-reward." Fidelity was only documented in one study. Good evidence was found for behavior change maintenance effects in healthy inactive adults, and underlying BCTs. This review provides translational evidence to improve research, intervention design, and service delivery in physical activity interventions, while highlighting the lack of fidelity measurement. |
| Audience | Academic |
| Author | Howlett, Neil Trivedi, Daksha Troop, Nicholas A Chater, Angel Marie |
| AuthorAffiliation | 3 Institute for Sport and Physical Activity Research (ISPAR), School of Sport Science and Physical Activity, Faculty of Education and Sport, University of Bedfordshire, Bedford, UK 4 UCL School of Pharmacy, Centre for Behavioural Medicine, Research Department of Practice and Policy, University College London, London, UK 1 Department of Psychology and Sport Sciences, University of Hertfordshire, Herts AL, UK 2 Centre for Research in Public Health and Community Care, University of Hertfordshire, College Lane, Hatfield, Herts AL, UK |
| AuthorAffiliation_xml | – name: 3 Institute for Sport and Physical Activity Research (ISPAR), School of Sport Science and Physical Activity, Faculty of Education and Sport, University of Bedfordshire, Bedford, UK – name: 1 Department of Psychology and Sport Sciences, University of Hertfordshire, Herts AL, UK – name: 2 Centre for Research in Public Health and Community Care, University of Hertfordshire, College Lane, Hatfield, Herts AL, UK – name: 4 UCL School of Pharmacy, Centre for Behavioural Medicine, Research Department of Practice and Policy, University College London, London, UK |
| Author_xml | – sequence: 1 givenname: Neil surname: Howlett fullname: Howlett, Neil organization: Department of Psychology and Sport Sciences, University of Hertfordshire, Herts AL, UK – sequence: 2 givenname: Daksha surname: Trivedi fullname: Trivedi, Daksha organization: Centre for Research in Public Health and Community Care, University of Hertfordshire, College Lane, Hatfield, Herts AL, UK – sequence: 3 givenname: Nicholas A surname: Troop fullname: Troop, Nicholas A organization: Department of Psychology and Sport Sciences, University of Hertfordshire, Herts AL, UK – sequence: 4 givenname: Angel Marie surname: Chater fullname: Chater, Angel Marie organization: Department of Psychology and Sport Sciences, University of Hertfordshire, Herts AL, UK, Institute for Sport and Physical Activity Research (ISPAR), School of Sport Science and Physical Activity, Faculty of Education and Sport, University of Bedfordshire, Bedford, UK, UCL School of Pharmacy, Centre for Behavioural Medicine, Research Department of Practice and Policy, University College London, London, UK |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29506209$$D View this record in MEDLINE/PubMed |
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| Snippet | Physical inactivity and sedentary behavior relate to poor health outcomes independently. Healthy inactive adults are a key target population for prevention.... Interventions in healthy adults who struggle to regularly exercise are effective in improving physical activity levels and maintaining this change at least 6... |
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| SubjectTerms | Behavior modification Behavior Therapy - methods Exercise Health aspects Health Behavior Health Promotion - methods Humans Intervention Medical research Medicine, Experimental Meta-analysis Physical fitness Sedentary Behavior Systematic review Systematic Reviews |
| Title | Are physical activity interventions for healthy inactive adults effective in promoting behavior change and maintenance, and which behavior change techniques are effective? A systematic review and meta-analysis |
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