Context Most adults do not achieve adequate physical activity. Despite the potential benefits of worksite health promotion, no previous comprehensive meta-analysis has summarized health and physical activity behavior outcomes from these programs. This comprehensive meta-analysis integrated the extant wide range of worksite physical activity intervention research. Evidence acquisition Extensive searching located published and unpublished intervention studies reported from 1969 through 2007. Results were coded from primary studies. Random-effects meta-analytic procedures, including moderator analyses, were completed in 2008. Evidence synthesis Effects on most variables were substantially heterogeneous because diverse studies were included. Standardized mean difference (d) effect sizes were synthesized across approximately 38,231 subjects. Significantly positive effects were observed for physical activity behavior (0.21), fitness (0.57), lipids (0.13), anthropometric measures (0.08), work attendance (0.19), and job stress (0.33). The significant effect size for diabetes risk (0.98) is more tentative given small sample sizes. Significant heterogeneity documents intervention effects varied across studies. The mean effect size for fitness corresponds to a difference between treatment minus control subjects' means on V02max of 3.5 mL/kg/min; for lipids, −0.2 on total cholesterol:HDL; and for diabetes risk, −12.6 mg/dL on fasting glucose. Conclusions These findings document that some workplace physical activity interventions can improve both health and important worksite outcomes. Effects were variable for most outcomes, reflecting the diversity of primary studies. Future primary research should compare interventions to confirm causal relationships and further explore heterogeneity.

Objective This meta-analysis summarized effects of interventions designed to increase physical activity among healthy adults. Methods Comprehensive searching located 358 reports eligible for inclusion. Random-effects analyses were used to synthesize data. Potential moderator variables were examined with meta-analytic analogues of ANOVA and regression. Moderator variable robustness and publication bias were explored. Results Meta-analytic results were computed from studies including 99,011 subjects. The overall mean effect size (d) for treatment vs. control groups comparisons was 0.19 (higher mean for treatment than control subjects). This 0.19 is consistent with a mean difference of 496 steps/day between treatment and control subjects. Exploratory moderator analyses suggested that the characteristics of the most effective interventions included behavioral interventions instead of cognitive interventions, face-to-face delivery versus mediated interventions (e.g. via telephone, mail, etc.), and targeted individuals instead of communities. Participant characteristics were unrelated to physical activity effect sizes. Substantial between-studies heterogeneity remained beyond individual moderators. Conclusions These findings suggest that interventions designed to increase activity are modestly effective. Findings suggest interventions should emphasize behavioral strategies over cognitive strategies to increase physical activity.

Research on racial comparisons of self-esteem was examined. Early research in this area, exemplified by the doll studies of racial preference, was viewed as demonstrating that Blacks have less self-regard than Whites. However, a meta-analytic synthesis of 261 comparisons, based largely on self-esteem scales and involving more than half a million respondents, revealed higher scores for Black than for White children, adolescents, and young adults. This analysis further revealed that the direction and magnitude of racial differences are influenced by such demographic characteristics as participant age and socioeconomic status, as well as by characteristics of the measuring instruments. Many findings--for example, that the self-esteem advantage for Black respondents increases with age and is related to the sex composition of the sample--underscore the need for long-term longitudinal studies of self-esteem development in male and female members of both racial groups.

Objective-This meta-analysis integrates primary research testing the effect of patient education to increase physical activity (PA) on behavior outcomes among adults with diverse chronic illnesses.Methods-Extensive literature searching strategies located published and unpublished intervention studies that measured PA behavior outcomes. Primary study results were coded. Fixed-and randomeffects meta-analytic procedures included moderator analyses.Results-Data were synthesized across 22,527 subjects from 213 samples in 163 reports. The overall mean weighted effect size for two-group comparisons was 0.45 (higher mean for treatment than control). This effect size is consistent with a difference of 48 minutes of PA per week or 945 steps per day. Preliminary moderator analyses suggest interventions were most effective when they targeted only PA behavior, used behavioral strategies (vs. cognitive strategies), and encouraged PA self-monitoring. Differences among chronic illnesses were documented. Individual strategies unrelated to PA outcomes included supervised exercise sessions, exercise prescription, fitness testing, goal setting, contracting, problem solving, barriers management, and stimulus/cues. PA outcomes were unrelated to gender, age, ethnicity, or socioeconomic distribution among samples.Conclusion-These findings suggest that some patient education interventions to increase PA are effective, despite considerable heterogeneity in the magnitude of intervention effect.Practice Implications-Moderator analyses are preliminary and provide suggestive evidence for further testing of interventions to inform practice.

The findings document that interventions increase MA in older adults. The considerable heterogeneity in the magnitude of effects across studies and results of the moderator analyses demonstrate the need for additional empirical research to optimize interventions.

Exercise interventions resulted in small positive effects on health and well-being outcomes among existing studies. Future research should examine intervention-specific characteristics that result in optimal results, such as dose.

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Aims/hypothesis The aim of this meta-analysis was to integrate the results of primary research testing the effect of diabetes self-management interventions that included recommendations to increase exercise on metabolic outcomes among adults with type 2 diabetes. Materials and methods Extensive literature searching strategies were used to identify published and unpublished intervention studies that measured glycated haemoglobin outcomes. Primary study results were coded. Fixed-and random-effects meta-analytic procedures included moderator analyses.Results Data were synthesised across 10,455 subjects from 103 research reports. The overall mean weighted effect size for two-group comparisons was 0.29 (higher mean for treatment than control). This effect size is consistent with a difference in HbA 1c means of 0.45% (e.g. 7.38% for treatment subjects vs 7.83% for control subjects). For single-group studies, the overall mean weighted effect size was 0.32-0.34. Control group subjects experienced no improvement in metabolic control during participation in the studies. Interventions that targeted multiple health behaviours resulted in smaller effect size estimates (0.22) than interventions that focused only on exercise behaviours (0.45). Funded studies reported greater improvements in metabolic controls. Studies with a greater proportion of female subjects reported lower effect sizes. Baseline HbA 1c and BMI were unrelated to metabolic outcomes. Conclusions/interpretation These findings suggest that self-management interventions that include exercise recommendations improve metabolic control, despite considerable heterogeneity in the magnitude of the intervention effect. Interventions that emphasise exercise may be especially effective in improving metabolic control. Primary research testing interventions in randomised trials to confirm causal relationships would be constructive.Keywords Diabetes mellitus, type 2 . Exercise . Haemoglobin A, glycosylated . HbA 1c . Meta-analysis Abbreviations CLES common language effect size ES effect size GhB glycated haemoglobin Diabetologia (2007) 50:913-921