Can lay-led walking programmes increase physical activity in middle aged adults? A randomised controlled trial

Lamb, Sarah E; Bartlett, Helen; Ashley, A. Fenner; Bird, William

doi:10.1136/jech.56.4.246

Cited by 82 publications

(108 citation statements)

References 17 publications

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“…They included five studies with measures of physical activity and reported significant effects for three of these studies. However, in two of the studies [30,31], the interventions were delivered by laypersons, not peers. Of the remaining three studies, none included an intervention specifically designed to increase physical activity-one intervention was designed to increase self-efficacy after myocardial infarction [32] and the other two were disease self-management programs [33,34].…”

Section: Peer Mentors and Health Intervention Deliverymentioning

confidence: 99%

Peer-delivered physical activity interventions: an overlooked opportunity for physical activity promotion

Ginis

Nigg

Smith

2013

Behav. Med. Pract. Policy Res.

199

176

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The purpose of this systematic review was to catalogue and synthesize published studies that have examined the effects of peer-delivered physical activity interventions on physical activity behavior. Ten published studies were identified that met the inclusion criteria. The following information was extracted from each study: study design and duration; characteristics of the sample, peers, and interventions; and physical activity outcomes. In all articles reporting within-groups analyses, peer-delivered interventions led to increases in physical activity behavior. When compared to alternatives, peer-delivered interventions were just as effective as professionally delivered interventions and more effective than control conditions for increasing physical activity. Only three studies included measures of social cognitive variables, yielding some evidence that peers may enhance self-efficacy and self-determined forms of motivation. Based on these findings, interventionists are encouraged to include peer mentors in their intervention delivery models. Investigators are encouraged to pursue a more comprehensive understanding of factors that can explain and maximize the impact of peer-delivered activity interventions. KeywordsExercise, Fitness, Peer mentors, Social influence, Social cognitive theory, Self-determination theory BACKGROUND Previous research has shown that regular physical activity (PA) contributes to the prevention of overweight/obesity [1-3], decreases risk for obesity-related illnesses [4,5], and is associated with decreased risk for coronary heart disease [6], hypertension, type 2 diabetes mellitus [1,2], and cancer at several sites [7]. These benefits have also been reported in subpopulations such as older adults [8] and persons with disabilities [9]. Unfortunately, most adults do not perform PA at the recommended level to experience such health benefits [10,11]. Indeed, 39 % of adults are completely sedentary [11], and the rate of inactivity increases with age [8,12] and physical impairment (e.g., [13]).Although health care professionals often hold a role of trusted counselor or health mentor for their

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Section: Peer Mentors and Health Intervention Deliverymentioning

confidence: 99%

Peer-delivered physical activity interventions: an overlooked opportunity for physical activity promotion

Ginis

Nigg

Smith

2013

Behav. Med. Pract. Policy Res.

199

176

View full text Add to dashboard Cite

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“…20,23 The duration of the schemes was 10 or 12 weeks in four RCTs, [18][19][20]23 4 months in one non-randomised study, 24 and up to 2 years in one RCT. 21 There appeared to be no time limit (or none mentioned) for the walking scheme reported by Lamb et al 22 The participants of most schemes were adults (mainly middle-aged) with sedentary lifestyles and cardiac risk factors, and the aims were to increase physical activity and reduce cardiac risk factors. The quality of these studies varied from 15 to 29 (median 26) out of a maximum of 34 on the quality score (Supplementary Table 3); 12 none of the RCTs scored less than 19.…”

Section: Controlled Studies Including Rctsmentioning

confidence: 99%

“…23 The unit of randomisation was the individual participant in five trials, [18][19][20]22,23 and the referring practice in one trial. 21 A non-randomised controlled study compared a walking programme for patients with type 2 diabetes with no programme.…”

Section: Controlled Studies Including Rctsmentioning

confidence: 99%

“…24 Participants were recruited from searches of primary care medical record databases in four RCTs. 18,19,21,22 They were selected for inclusion on the basis of coronary heart disease (CHD) risk factors, 18,23 or according to the results of a returned physical activity questionnaire. 19,21,22 Participants were recruited by clinicians in two RCTs from UK exercise-referral schemes that were already accepting referrals from primary care.…”

Section: Controlled Studies Including Rctsmentioning

confidence: 99%

“…18,19,21,22 They were selected for inclusion on the basis of coronary heart disease (CHD) risk factors, 18,23 or according to the results of a returned physical activity questionnaire. 19,21,22 Participants were recruited by clinicians in two RCTs from UK exercise-referral schemes that were already accepting referrals from primary care. 20,23 The duration of the schemes was 10 or 12 weeks in four RCTs, [18][19][20]23 4 months in one non-randomised study, 24 and up to 2 years in one RCT.…”

Section: Controlled Studies Including Rctsmentioning

confidence: 99%

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Effectiveness of exercise-referral schemes to promote physical activity in adults: systematic review

et al. 2007

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MethodStudies were identified by searching MEDLINE, CINAHL, EMBASE, AMED, PsycINFO, SPORTDiscus, The Cochrane Library and SIGLE until March 2007. Randomised controlled trials (RCTs), observational studies, process evaluations and qualitative studies of exercise-referral schemes, defined as referral by a primary care clinician to a programme that encouraged physical activity or exercise were included. RCT results were combined in a meta-analysis where there was sufficient homogeneity. ResultsEighteen studies were included in the review. These comprised six RCTs, one non-randomised controlled study, four observational studies, six process evaluations and one qualitative study. In addition, two of the RCTs and two of the process evaluations incorporated a qualitative component. Results from five RCTs were combined in a meta-analysis. There was a statistically significant increase in the numbers of participants doing moderate exercise with a combined relative risk of 1.20 (95% confidence intervals = 1.06 to 1.35). This means that 17 sedentary adults would need to be referred for one to become moderately active. This small effect may be at least partly due to poor rates of uptake and adherence to the exercise schemes. ConclusionExercise-referral schemes have a small effect on increasing physical activity in sedentary people. The key challenge, if future exercise-referral schemes are to be commissioned by the NHS, is to increase uptake and improve adherence by addressing the barriers described in these studies.

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Interventions for promoting physical activity

Foster

Hillsdon

Thorogood

et al. 2005

Cochrane Database of Systematic Reviews

412

259

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Background Little is known about the effectiveness of strategies to enable people to achieve and maintain recommended levels of physical activity. Objectives To assess the effectiveness of interventions designed to promote physical activity in adults aged 16 years and older, not living in an institution. Search methods We searched The Cochrane Library (issue 1 2005), MEDLINE, EMBASE, CINAHL, PsycLIT, BIDS ISI, SPORTDISCUS, SIGLE, SCISEARCH (from earliest dates available to December 2004). Reference lists of relevant articles were checked. No language restrictions were applied. Selection criteria Randomised controlled trials that compared different interventions to encourage sedentary adults not living in an institution to become physically active. Studies required a minimum of six months follow up from the start of the intervention to the collection of final data and either used an intention-to-treat analysis or, failing that, had no more than 20% loss to follow up. Data collection and analysis At least two reviewers independently assessed each study quality and extracted data. Study authors were contacted for additional information where necessary. Standardised mean differences and 95% confidence intervals were calculated for continuous measures of self-reported physical activity and cardio-respiratory fitness. For studies with dichotomous outcomes, odds ratios and 95% confidence intervals were calculated. Main results The effect of interventions on self-reported physical activity (19 studies; 7598 participants) was positive and moderate (pooled SMD random effects model 0.28 95% CI 0.15 to 0.41) as was the effect of interventions (11 studies; 2195 participants) on cardio-respiratory fitness (pooled SMD random effects model 0.52 95% CI 0.14 to 0.90). There was significant heterogeneity in the reported effects as well as heterogeneity in characteristics of the interventions. The heterogeneity in reported effects was reduced in higher quality studies, when physical activity was self-directed with some professional guidance and when there was on-going professional support. Authors’ conclusions Our review suggests that physical activity interventions have a moderate effect on self-reported physical activity, on achieving a predetermined level of physical activity and cardio-respiratory fitness. Due to the clinical and statistical heterogeneity of the studies, only limited conclusions can be drawn about the effectiveness of individual components of the interventions. Future studies should provide greater detail of the components of interventions.

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Can lay-led walking programmes increase physical activity in middle aged adults? A randomised controlled trial

Cited by 82 publications

References 17 publications

Peer-delivered physical activity interventions: an overlooked opportunity for physical activity promotion

Peer-delivered physical activity interventions: an overlooked opportunity for physical activity promotion

Effectiveness of exercise-referral schemes to promote physical activity in adults: systematic review

Interventions for promoting physical activity

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