Best Practices for Meta-Reviews in Physical Activity and Health Research: Insights From the Physical Activity Guidelines for Americans Advisory Committee Scientific Report

Abstract

Background: Systematic reviews (SRs) and meta-analyses (MAs) have proliferated with a concomitant increase in reviews of SRs/MAs or “meta-reviews” (MRs). As uncovered by the 2018 US Physical Activity Guidelines Advisory Committee (PAGAC), there is a paucity of best practice guidance on MRs on physical activity health-related research. This manuscript aims to fill this gap. Methods: In total, the PAGAC conducted 38 literature searches across 3 electronic databases and triaged 20,838 titles, 4913 abstracts, and 2139 full texts from which 1130 articles qualified for the PAGAC Scientific Report. Results: During the MR process, the following challenges were encountered: (1) if the SR/MA authors had limited experience in synthesis methodology, they likely did not account for risk of bias in the conclusions they reached; (2) many SRs/MAs reviewed the same primary-level studies; (3) many SRs/MAs failed to disclose effect modifier analyses; (4) source populations varied; (5) physical activity exposures were nonstandardized; and (6) dose–response effects or effect modification of the physical activity exposure could not be identified. Conclusions: Using examples from the PAGAC Scientific Report, we provide (1) a high-level introduction to MRs; (2) recommended steps in conducting a MR; (3) challenges that can be encountered; and (4) guidance in addressing these challenges.

Health, Performance Ratings and Approachability of 50–60 Year Old Sedentary Adults (ActIv-Study): Key Insights for Health Economy and Exercise Promotion

“…Negative everyday habits such as lack of exercise and a hypercaloric diet not only lead to widespread chronic diseases and escalating medical expenses but also inflict considerable financial damage in the workplace [54][55][56][57][58][59]. Well before the onset of obesity and chronic illnesses (e.g.…”

“…Well before the onset of obesity and chronic illnesses (e.g. diabetes, fatty liver, circulatory diseases), employees often experience reduced resilience, declining productivity and a significant drop in performance [33,44,57,[60][61][62].…”

Proactive Behavior Change Techniques (ProBCTs) in Physical Activity and Healthy Eating

“…But even at this meta-level, it is difficult to keep track of the existing research and draw meaningful conclusions. For example, searches of PubMed conducted by Pescatello et al [34] revealed 76´768 "reviews on physical activity" (from 1843 to 2021) and 6076 "systematic reviews (SRs) and meta-analyses (MAs) on physical activity" (from 1996 to 2021), as well as several other types of reviews published by 2021. Consequently, meta-reviews are used to summarize evidence on the meta-level [35] systematic reviews of systematic reviews and meta-analyses ("reviews of reviews") [6].…”

“…In summary, there is an entire taxonomy of behavior change techniques and a wealth of empirical studies investigating their effectiveness for health promotion. Further, there is no lack of well-defined and high research standards [39], nor of recommendations for designing and examining interventions in a methodologically rigorous way [34,40]. And yet progress in health behavior change urgently needs to be accelerated and to become more pronounced to match the scale of the problem [41].…”

The Temporal Association between Body Characteristics and Speed Performance over Twenty-Five Years in Italian Adolescents

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