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Lauren Ashleigh Waters, Benedicte Galichet, Neville Owen and Elizabeth Eakin

Background:

Taking a representative snapshot of physical activity intervention trial findings published between 1996 and 2006, we empirically evaluated participant characteristics, response and retention rates, and their associations with intervention settings.

Methods:

A structured database search identified 5 representative health behavior journals, from which 32 research reports of physical activity intervention trials were reviewed. Interventions settings were categorized as workplace, healthcare, home- or community-based. Information on participant and intervention characteristics was extracted and reviewed.

Results:

The majority of participants were Caucasian (86%), women (66%), healthy but sedentary (63%), and middle-aged (mean age = 51 years). Intervention response rates ranged from 20% to 89%, with the greatest response rate for healthcare and home-based interventions. Compared with nonparticipants, study participants tended to be women, Caucasian, tertiary-educated, and middle-class. Participants in workplace interventions were younger, more educated, and healthier; in community-based interventions, participants were older and more ethnically diverse. Reporting on education and income was inconsistent. The mean retention rate was 78%, with minimal differences between intervention settings.

Conclusions:

These results emphasize the need for physical activity interventions to target men, socioeconomically disadvantaged, and ethnic minority populations. Consistent reporting of response rate and retention may enhance the understanding of which intervention settings best recruit and retain large, representative samples.

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Lauren Waters, Marina Reeves, Brianna Fjeldsoe and Elizabeth Eakin

Background:

Several recent physical activity intervention trials have reported physical activity improvements in control group participants. Explanations have been proposed, but not systematically investigated.

Methods:

A systematic review of physical activity intervention trials was conducted to investigate the frequency of meaningful improvements in physical activity among control group participants (increase of ≥ 60 minutes [4 MET·hours] of moderate-to-vigorous physical activity per week, or a 10% increase in the proportion of participants meeting physical activity recommendations), and possible explanatory factors. Explanatory factors include aspects of behavioral measurement, participant characteristics, and control group treatment.

Results:

Eight (28%) of 29 studies reviewed reported meaningful improvements in control group physical activity, most of which were of similar magnitude to improvements observed in the intervention group. A number of factors were related to meaningful control group improvements in physical activity, including the number of assessments, mode of measurement administration, screening to exclude active participants, and preexisting health status.

Conclusions:

Control group improvement in physical activity intervention trials is not uncommon and may be associated with behavioral measurement and participant characteristics. Associations observed in this review should be evaluated empirically in future research. Such studies may inform minimal contact approaches to physical activity promotion.

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Jill A. Bennett, Kerri Winters-Stone, Lillian M. Nail and Jennifer Scherer

This review describes the definitions of sedentary used to screen community-dwelling adults in physical-activity-intervention trials published from 2000 to 2005. Results of 42 trials showed that definitions of sedentary varied from <20 to <150 min/week of physical activity, and few reported the type (work, household, or leisure) or intensity of activity that was used to screen participants. The range of “sedentary” samples makes it difficult to compare trial results or generalize findings. Published reports of exercise trials would be more useful to practitioners and researchers if they included an explicit description of the cut point used to define sedentary adults in the sample, in terms of maximum minutes or days per week of activity and the wording of the screening measure in terms of type and intensity of activity.

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Marina M. Reeves, Alison L. Marshall, Neville Owen, Elisabeth A.H. Winkler and Elizabeth G. Eakin

Background:

We compared the responsiveness to change (prepost intervention) of 3 commonly-used self-report measures of physical activity.

Methods:

In a cluster-randomized trial of a telephone-delivered intervention with primary care patients, physical activity was assessed at baseline and 4 months (n = 381) using the 31-item CHAMPS questionnaire; the 6-item Active Australia Questionnaire (AAQ); and, 2 walking for exercise items from the US National Health Interview Survey (USNHIS). Responsiveness to change was calculated for frequency (sessions/week) and duration (MET·minutes/week) of walking and moderate-to-vigorous intensity physical activity.

Results:

The greatest responsiveness for walking frequency was found with the USNHIS (0.45, 95% CI: 0.19, 0.72) and AAQ (0.43, 95% CI: 0.19, 0.67), and for walking duration with the USNHIS (0.27, 95%CI 0.13, 0.41) and CHAMPS (0.24, 95% CI: 0.12, 0.36). For moderate-to-vigorous activity, responsiveness for frequency was slightly higher for the AAQ (0.50, 95% CI: 0.30, 0.69); for duration it was slightly higher for CHAMPS (0.32, 95% CI: 0.17, 0.47).

Conclusions:

In broad-reach trials, brief self-report measures (USNHIS and AAQ) are useful for their comparability to population physical activity estimates and low respondent burden. These measures can be used without a loss in responsiveness to change relative to a more detailed self-report measure (CHAMPS).

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Lisa K. Sharp, Marian L. Fitzgibbon and Linda Schiffer

Background:

Despite the increased health risks for obese Black women, relatively little research has explored physical activity and nutrition interventions for these women. This article describes the recruitment strategies used in a program designed specifically for obese Black women.

Methods:

Recruitment of Black women age 30 to 65 years with body mass indices between 30 kg/m2 and 50 kg/m2 was completed using in-person recruitment and flyers within 2 miles of the intervention site along with mass e-mails within the sponsoring university system. Medical clearance from a physician was an eligibility requirement because of Institutional Review Board safety concerns.

Results:

Of the 690 women who were screened, 213 (31%) were eligible and randomized. The most common reason for exclusion was failure to return a medical clearance form (n = 167, 39% of ineligible). Different rates of efficiency were noted across recruitment approaches.

Conclusions:

Black women were successfully recruited using in-person community recruitment, e-mail, and community flyers within close proximity to the intervention site. Careful consideration should be given to the advantages and disadvantages of various recruitment strategies that might not generalize across studies.

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Beth A. Lewis, LeighAnn H. Forsyth, Bernardine M. Pinto, Beth C. Bock, Mary Roberts and Bess H. Marcus

Behavioral science theories have been used to develop physical activity interventions; however, little is known as to whether these interventions are effective due to changes in constructs related to these theories. Specifically, if the intervention is successful, does it work for the reasons hypothesized by the theory underlying it? The purpose of this study was to examine the importance of particular theoretical constructs among participants (n = 150) who had been randomly assigned to a physical activity intervention based on the Transtheoretical Model and Social Cognitive Theory (i.e., tailored group) or to a standard care group. Participants in the tailored group reported greater increases in behavioral processes and self-efficacy from baseline to 3 months than participants in the standard-care group. No between-group differences were found for cognitive processes and decisional balance. This study demonstrates that theory-based physical activity interventions may be effective through changes in particular theoretical constructs.

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Abby Haynes, Catherine Sherrington, Geraldine Wallbank, David Lester, Allison Tong, Dafna Merom, Chris Rissel and Anne Tiedemann

The Coaching for Healthy Ageing trial evaluated the impact on physical activity (PA) and falls based on a year-long intervention in which participants aged 60+ receive a home visit, regular health coaching by physiotherapists, and a free activity monitor. This interview study describes the participants’ experiences of the intervention and ideas for improvement. The authors sampled purposively for maximum variation in experiences. The data were analyzed thematically by two researchers. Most of the 32 participants reported that the intervention increased PA levels, embedded activities, and generated positivity about PA. They were motivated by quantified PA feedback, self-directed goals, and person-centered coaching. Social connectivity motivated some, but the intervention did not support this well. The intervention structure allowed participants to trial and embed activities. Autonomy and relatedness were emphasized and should be included in future program theory. The authors identified synergistic effects, likely “essential ingredients,” and potential areas for improving this and similar interventions.

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Kirsty A. Fairbairn, Ingrid J.M. Ceelen, C. Murray Skeaff, Claire M. Cameron and Tracy L. Perry

, preventing a small seasonal decline in serum vitamin D status of approximately 15 nmol/L over autumn. However, vitamin D supplementation did not affect our primary outcome variable of 30-m sprint time in these professional NZ male rugby union players. Intervention trials investigating vitamin D

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Holly R. Wyatt, John C. Peters, George W. Reed, Gary K. Grunwald, Mary Barry, Helen Thompson, Joanie Jones and James O. Hill

Background:

Obesity is an epidemic in the United States, yet few programs have been implemented on a widespread basis to deal with it. Colorado on the Move is a state-wide program with a specific quantifiable behavioral goal for increasing lifestyle physical activity (i.e. walking) and decreasing energy intake to prevent weight gain.

Methods:

A nonrandomized intervention trial designed to increase walking by 2000 steps/d using electronic step counters.

Results:

The intervention was effective in increasing average steps/d by at least 2000 over a 14-wk period.

Conclusion:

The Colorado on the Move intervention was effective in significantly increasing physical activity over a 14-wk period. Steps/d appears to be a good target for use in interventions to increase physical activity. Simply increasing physical activity in the population by 2000 steps/d could help in preventing the average yearly increase in body weight seen in the US population.

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Susan I. Barr and Heather A. McKay

The maximal amount of bone mass gained during growth (peak bone mass) is an important determinant of bone mass in later life and thereby an important determinant of fraeiure risk. Although genetic factors appear lo be primary determinants of peak bone mass, environmental factors such as physical activity and nutrition also contribute. In this article, bone growth and maintenance are reviewed, and mechanisms are described whereby physical activity can affect bone mass. Studies addressing the effects of physical activity on bone status in youth are reviewed: Although conclusive data are not yet available, considerable evidence supports the importance of activity, especially activity initiated before puberty. The critical role of energy in bone growth is outlined, and studies assessing the impact of calcium intake during childhood and adolescence are reviewed. Although results of intervention trials are equivocal, other evidence supports a role for calcium intake during growth. Recommendations for physical activity and nutrition, directed lochildren and adolescents, are presented.