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Research overview

Effects of campaigns and other communication initiatives on physical activity with one or more other lifestyle habits targeting the general population

This review looks at the effects of information and other communication initiatives on physical activity and on changes in one or more other lifestyle habit.


  • Issued/Revised: 2015
  • Austvoll-Dahlgren A, Lidal IB, Mosdøl A, Odgaard-Jensen J, Denison E, Vist GE. Effects of campaigns and other communication initiatives on physical activity with one or more other lifestyle habits targeting the general population. Research overview 2015. ISBN (digital): 978-82-8121-954-0, ISSN (digital): 1890-1298. Available at www.fhi.no/en

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Key message

Low level of physical activity is often associated with other unhealthy behaviors, such as smoking or poor diet. When promoting good health and preventing illness on a population level, it might be a good idea to target several health behaviors in the same communication strategy. This systematic review looks at the effects of information and other communication initiatives on physical activity and on changes in one or more other lifestyle habit.

The results of information and other communication initiatives show:

  • Physical activity: increase in total amount of measured activity up to 6 months; little or no differences at longer follow up times.
  • Intake of calories: unclear results up to 6 months, reduced intake between 13 and 24 months; unclear results at longer follow up times.
  • Intake of fruit and vegetables: increased up to 6 months; little or no difference at longer follow up times.
  • Use of computers and electronic games: small reduction measured up 12 months; little or no difference at longer follow up times.
  • Self efficacy of diet, and self efficacy of diet and of physical activity: small increase up to 6 months, little or no difference for self efficacy of physical activity alone; no difference at longer follow up times.
  • Body mass index, smoking and alcohol intake: unclear results.

Summary

Background

Low level of physical activity is often associated with other unhealthy behaviors, such as smoking or poor diet. When promoting good health and preventing illness on a population level, it might be a good idea to target several health behaviors in the same communication strategy. This systematic review looks at the effects of information and other communication initiatives on physical activity and on changes in one or more other lifestyle habit.

Objective

The aim of this systematic review is to assess the effect of:

1) information and communication initiatives targeting physical activity and one or more other lifestyle habit,

2) information and communication initiatives targeting physical activity where the effect is also measured on other lifestyle habits.

Method

We conducted a systematic literature search in relevant databases, with additional searches of reference lists in relevant systematic reviews. We contacted authors of protocols and conference abstracts asking for relevant studies. Searches were conducted December 2012. Two authors individually assessed abstracts and citations for inclusion. All references that were considered possibly relevant were read in full text. Two authors assessed the risk of bias. We included all studies that met our inclusion criteria. Interventions were targeted to populations, i.e. a large group of people (children, adults, and elderly). Relevant outcomes were health, attitude, self efficacy, knowledge, health behaviour, use of health services and costs. Two authors extracted data from the studies. We assessed our confidence in the results using GRADE (Grading, Assessment, Development, and Evaluation).

Results

The majority of the interventions were complex interventions targeting several population groups, several lifestyle habits, and used several measures simultaneously. The interventions were given to families, local communities,  schools, work places, religious meeting places, and at places for leasure time activities. The interventions focused on two to five lifestyle habits in addition to physical activity: diet, alcohol, tabacco, drugs, computer and electronic games. The most common interventions were information campaigns in mass media at the local level, at schools or work places. Other components of the interventions included changes in structure or changes in organisation in order to facilitate physical activity by, for example, organising physical activities, creating walkways, providing access to sports equipment or healthier foods. Others changed laws and regulations such as banning smoking at work.

We included 79 comparisons (from 75 studies) conducted in 22 different countries. Seventyeight comparisons addressed interventions at population level to encourage physical activity with change in one or more other lifestyle habit. The results of information and other communication initiatives show:

  • Physical activity: increase in total amount of measured activity up to 6 months; little or no differences at longer follow up times.
  • Intake of calories: unclear results up to 6 months, reduced intake between 13 and 24 months; unclear results at longer follow up times.
  • Intake of fruit and vegetables: increased up to 6 months; little or no difference at longer follow up times.
  • Use of computers and electronic games: small reduction measured up 12 months; little or no difference at longer follow up times.
  • Self efficacy of diet, and self efficacy of diet and of physical activity: small increase up to 6 months, little or no difference for self efficacy of physical activity alone; no difference at longer follow up times.
  • Body mass index, smoking and alcohol intake: unclear results.

One comparison addressed information and communication initiatives targeting physical activity compared to targeting improved diet. Results are sparse but indicate that there may be little or no difference at 7 to 12 months on physical activity or body mass index. We are uncertain if self efficacy or diet was affected.

Discussion

Complex interventions like those assessed in this systematic review are difficult to design, and to implement. Moreover, it is difficult to evaluate their effect. The fact that we found 59 randomized controlled trials shows that it is possible to do this using good research designs. However, interpretation of the results from complex and multi component interventions are difficult, and these are very complex interventions.  

However, the fact that many and different interventions conducted in many different settings and in many combinations yield similar results adds confidence to the conclusions.

The strength of this systematic review is that we use systematic, explicit and transparent criteria for identifying, including and assessing the quality of the relevant studies. It has been a challenge to identify and place the relevant literature for many reasons. There are many publications for each study (and hence, for each comparison); there is duplication of data; and in many studies, reporting about the methods used, analysis and results is incomplete.

Conclusion

Information and communication initiatives targeting physical activity and one or more other lifestyle habit results in several important benefits that lasted up to 6 months. Not surprisingly, these benefits were reduced or have disappeared at longer follow up times.

This systematic review is based on a two year old literature search. We encourage an update, and we suggest that it will suffice to include randomized controlled trials only.

This is a publication from the Norwegian Knowledge Centre for the Health Services. The Knowledge Centre became part of the Norwegian Institute of Public Health 01/01/2016.

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