Background: Structured physical activity (PA) interventions (ie, intentionally planned) can be implemented in a variety of facilities, and therefore can reach a large proportion of the population. The aim of the authors was to summarize the effectiveness of structured interventions upon PA outcomes, in addition to proportions of individuals adopting and maintaining PA, and adherence and retention rates. Methods: Systematic review with narrative synthesis and exploratory meta-analyses. Twelve studies were included. Results: Effectiveness on PA levels during adoption (pre- to first time point) showed a trivial standardized effect (0.15 [−0.06 to 0.36]); during maintenance (any time point after the first and >6 mo since initiation) the standardized effect was also trivial with a wide interval estimate (0.19 [−0.68 to 1.07]). Few studies reported adoption (k = 3) or maintenance rates (k = 2). Retention at follow-up did not differ between structured PA or controls (75.1% [65.0%–83.0%] vs 75.4% [67.0%–82.3%]), nor did intervention adherence (63.0% [55.6%–69.6%] vs 77.8% [19.4%–98.1%]). Conclusion: Structured PA interventions lack evidence for effectiveness in improving PA levels. Furthermore, though retention is often reported and is similar between interventions and controls, adoption, maintenance, and adherence rates were rarely reported rendering difficulty in interpreting results of effectiveness of structured PA interventions.
Nadja Willinger, James Steele, Lou Atkinson, Gary Liguori, Alfonso Jimenez, Steve Mann, and Elizabeth Horton
Nikita Rowley, James Steele, Matthew Wade, Robert James Copeland, Steve Mann, Gary Liguori, Elizabeth Horton, and Alfonso Jimenez
Objectives: To examine if exercise referral schemes (ERSs) are associated with meaningful changes in physical activity in a large cohort of individuals throughout England, Scotland, and Wales from The National Referral Database. Methods: Data were obtained from 5246 participants from 12 different ERSs, lasting 6–12 weeks. The preexercise referral scheme and changes from the preexercise to the postexercise referral scheme in self-reported International Physical Activity Questionnaire scores were examined. A 2-stage individual patient data meta-analysis was used to generate the effect estimates. Results: For the pre-ERS metabolic equivalent (MET) minutes per week, the estimate (95% confidence interval [CI]) was 676 MET minutes per week (539 to 812). For the change in MET minutes per week, the estimate (95% CI) was an increase of 540 MET minutes per week (396 to 684). Changes in the total PA levels occurred as a result of increases in vigorous activity of 17 minutes (95% CI, 9 to 24), increases in moderate activity of 29 minutes (95% CI, 22 to 36), and reductions in sitting of −61 minutes (95% CI, −78 to −43), though little change in walking (−5 min; 95% CI, −14 to 5) was found. Conclusions: Most participants undergoing ERSs are already “moderately active.” Changes in PA behavior associated with participation are through increased moderate to vigorous PA and reduced sitting. However, this was insufficient to change the International Physical Activity Questionnaire category, and the participants were still “moderately active.”