Interventions to improve physical activity among socioeconomically disadvantaged groups: an umbrella review

Abstract

BackgroundPeople from socioeconomically disadvantaged population groups are less likely to be physically active and more likely to experience adverse health outcomes than those who are less disadvantaged. In this umbrella review we examined across all age groups, (1) the effectiveness of interventions to improve physical activity among socioeconomically disadvantaged groups, (2) the characteristics of effective interventions, and (3) directions for future research.MethodsPubMed/MEDLINE and Scopus were searched up to May 2017 to identify systematic reviews reporting physical activity interventions in socioeconomically disadvantaged populations or sub-groups. Two authors independently conducted study screening and selection, data extraction (one author, with data checked by two others) and assessment of methodological quality using the ‘Assessment of Multiple Systematic Reviews’ scale. Results were synthesized narratively.ResultsSeventeen reviews met our inclusion criteria, with only 5 (30%) reviews being assessed as high quality. Seven (41%) reviews focused on obesity prevention and an additional four focused on multiple behavioural outcomes. For pre school children, parent-focused, group-based interventions were effective in improving physical activity. For children, school-based interventions and policies were effective; few studies focused on adolescents and those that did were generally not effective; for adults, there was mixed evidence of effectiveness but characteristics such as group-based interventions and those that focused on physical activity only were associated with effectiveness. Few studies focused on older adults. Across all ages, interventions that were more intensive tended to be more effective. Most studies reported short-term, rather than longer-term, outcomes and common methodological limitations included high probability of selection bias, low response rates, and high attrition.ConclusionsInterventions can be successful at improving physical activity among children from socioeconomically disadvantaged groups, with evidence for other age groups weak or inconclusive. More high-quality studies in this population group are needed, which adopt strategies to increase recruitment rates and reduce attrition, report longer term outcomes, and provide adequate intervention details, to allow determination of the characteristics of effective interventions. We recommend that the benefits of physical activity be recognised more broadly than obesity prevention in future studies, as this may have implications for the design and appeal of interventions.Electronic supplementary materialThe online version of this article (10.1186/s12966-018-0676-2) contains supplementary material, which is available to authorized users.

Socioeconomic inequalities in effectiveness of and compliance to workplace health promotion programs: an individual participant data (IPD) meta-analysis

“…Presumably, more drastic changes to the (economic, physical, social/cultural or political) environment are needed to introduce more substantial changes in physical activity and dietary choices [ 43 ]. In integrated programs, such elements should preferably be combined with additional effective components for low SEP workers as found in our study, such as intense (multi-session) programs [ 12 ] and messages tailored to the target population [ 14 ].…”

“…Larger effects among workers in high compared to low socioeconomic position (SEP) groups in health promotion programs, mainly in programs with educational components, were reported in a systematic review [ 12 ]. Both the initial participation and compliance in such programs is generally lower among workers with a lower SEP [ 12 – 14 ]. However, a systematic review on initial participation in workplace health promotion did not find a consistently lower participation among workers in lower SEP [ 15 ].…”

Walking soccer: A systematic review of a modified sport

“…[50][51][52] This is reinforced by previous research which shows that group-based physical activity interventions can be more effective than individuals participating in home-based physical activity, and groups support long-term adherence. [53][54][55] Thus, walking soccer may be a more attractive approach to engage people in physical activity. Promoting walking soccer as an opportunity to build or maintain social networks, rather than focusing on "exercise" may support its uptake by some adults.…”

Perceptions of active and inactive prototypes are associated with objective measures of physical activity in adolescents

“…active as they move through adolescence (Inchley et al, 2016). Evidence for successful strategies to increase physical activity (PA) in this age group is mixed, but stronger effects are found in programmes based on theories that aim to predict PA in relation to a set of psychological constructs such as attitudes and intentions (Craike et al, 2018). Exploring theories that might identify successful intervention targets in this age group is therefore important (Michie et al, 2008).…”