A community-wide campaign to promote physical activity in middle-aged and elderly people: a cluster randomized controlled trial

International Journal of Behavioral Nutrition and Physical Activity

Kuninori Shiwaku¹  Hiroharu Kamioka⁸  Kazuhiro Harada⁹  Shimpei Okada²  Hiromu Nishiuchi³  Yoshiki Ishikawa⁶  Shigeru Inoue⁵  Jun Kitayuguchi⁴  Masamitsu Kamada⁷ 

[1] Department of Environmental and Preventive Medicine, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan;Physical Education and Medicine Research Foundation, 6-1 Nunoshita, Tomi, Nagano 389-0402, Japan;Data Science Research Institute, 3-10-41 Minami-Aoyama, Minato-ku, Tokyo 107-0062, Japan;Physical Education and Medicine Research Center UNNAN, 1212-3 Mitoya, Mitoya-cho, Unnan, Shimane 690-2404, Japan;Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan;Department of Public Health, Jichi Medical School, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan;Japan Society for the Promotion of Science, 5-3-1 Koujimachi, Chiyoda-ku, Tokyo 102-8471, Japan;Faculty of Regional Environment Science, Tokyo University of Agriculture, 1-1-1 Sakuragaoka, Setagaya-ku, Tokyo 156-8502, Japan;Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama 359-1192, Japan

关键词: Social marketing;    Health communication;    Musculoskeletal diseases;    Resistance training;    Muscle stretching exercises;    Walking;   

Others  :  810493
DOI  :  10.1186/1479-5868-10-44

 received in 2012-09-11, accepted in 2013-03-29,  发布年份 2013

【 摘 要 】

Background

We aimed to evaluate the effectiveness of a community-wide campaign (CWC) for promoting physical activity in middle-aged and elderly people.

Methods

A cluster randomized controlled trial (RCT) with a community as the unit of randomization was performed using a population-based random-sampled evaluation by self-administered questionnaires in the city of Unnan, Shimane Prefecture, Japan. The evaluation sample included 6000 residents aged 40 to 79 years. We randomly allocated nine communities to the intervention group and three to the control group. The intervention was a CWC from 2009 to 2010 to promote physical activity, and it comprised information, education, and support delivery. The primary outcome was a change in engaging in regular aerobic, flexibility, and/or muscle-strengthening activities evaluated at the individual level.

Results

In total, 4414 residents aged 40–79 years responded to a self-administered questionnaire (73.6% response rate). Awareness of the CWC was 79% in the intervention group. Awareness and knowledge were significantly different between the intervention and control groups, although there were no significant differences in belief and intention. The 1-year CWC did not significantly promote the recommended level of physical activity (adjusted odds ratio: 0.97; 95% confidence interval: 0.84–1.14).

Conclusions

This cluster RCT showed that the CWC did not promote physical activity in 1 year. Significant differences were observed in awareness and knowledge between intervention and control groups as short-term impacts of the campaign.

Trial registration

UMIN-CTR UMIN000002683

【 授权许可】

   
2013 Kamada et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A: Physical Activity and Public Health. Updated Recommendation for Adults From the American College of Sports Medicine and the American Heart Association. Circulation 2007, 116(9):1081-1093.
• [2]World Health Organization (WHO): Global recommendations on physical activity for health. Geneva, Switzerland: WHO; 2010.
• [3]U.S. Department of Health and Human Services: 2008 Physical Activity Guidelines for Americans. Washington, DC, U.S.A.: U.S. Department of Health and Human Services; 2008.
• [4]European Commission: EU physical activity guidelines. Recommended policy actions in support of health-enhancing physical activity. http://ec.europa.eu/youth/news/eu-physical-activity-guidelines_en.htm webcite
• [5]Ministry of Health, Labour, and Welfare of Japan: Exercise and Physical Activity Reference for Health Promotion 2006 (EPAR2006): physical activity, exercise, and physical fitness (English Ver.). 2007. http://www0.nih.go.jp/eiken/programs/pdf/epar2006.pdf webcite
• [6]Bauman A, Bull F, Chey T, Craig CL, Ainsworth BE, Sallis JF, Bowles HR, Hagstromer M, Sjostrom M, Pratt M: The International Prevalence Study on Physical Activity: results from 20 countries. Int J Behav Nutr Phys Act 2009, 6(1):21. BioMed Central Full Text
• [7]Guthold R, Ono T, Strong KL, Chatterji S, Morabia A: Worldwide variability in physical inactivity a 51-country survey. Am J Prev Med 2008, 34(6):486-494.
• [8]Trost SG, Owen N, Bauman AE, Sallis JF, Brown W: Correlates of adults’ participation in physical activity: review and update. Med Sci Sports Exerc 2002, 34(12):1996-2001.
• [9]Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJ, Martin BW: Correlates of physical activity: why are some people physically active and others not? Lancet 2012, 380(9838):258-271.
• [10]Heath GW, Parra DC, Sarmiento OL, Andersen LB, Owen N, Goenka S, Montes F, Brownson RC: Evidence-based intervention in physical activity: lessons from around the world. Lancet 2012, 380(9838):272-281.
• [11]Guide to Community Preventive Services: Campaigns and informational approaches to increase physical activity: community-wide campaigns. http://www.thecommunityguide.org/pa/campaigns/community.html webcite
• [12]Kahn EB, Ramsey LT, Brownson RC, Heath GW, Howze EH, Powell KE, Stone EJ, Rajab MW, Corso P: The effectiveness of interventions to increase physical activity. A systematic review. Am J Prev Med 2002, 22(4 Suppl):73-107.
• [13]Beaudoin CE, Fernandez C, Wall JL, Farley TA: Promoting healthy eating and physical activity short-term effects of a mass media campaign. Am J Prev Med 2007, 32(3):217-223.
• [14]Luepker RV, Murray DM, Jacobs DR Jr, Mittelmark MB, Bracht N, Carlaw R, Crow R, Elmer P, Finnegan J, Folsom AR, Grimm R, Hannan PJ, Jeffrey R, Lando H, McGovern P, Mullis R, Perry CL, Pechacek T, Pirie P, Sprafka JM, Weisbrod R, Blackburn H: Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program. Am J Public Health 1994, 84(9):1383-1393.
• [15]Reger-Nash B, Bauman A, Booth-Butterfield S, Cooper L, Smith H, Chey T, Simon KJ: Wheeling walks: evaluation of a media-based community intervention. Fam Community Health 2005, 28(1):64-78.
• [16]Reger-Nash B, Bauman A, Cooper L, Chey T, Simon KJ, Brann M, Leyden KM: WV Walks: replication with expanded reach. J Phys Act Health 2008, 5(1):19-27.
• [17]Renger R, Steinfelt V, Lazarus S: Assessing the effectiveness of a community-based media campaign targeting physical inactivity. Fam Community Health 2002, 25(3):18-30.
• [18]Tudor-Smith C, Nutbeam D, Moore L, Catford J: Effects of the Heartbeat Wales programme over five years on behavioural risks for cardiovascular disease: quasi-experimental comparison of results from Wales and a matched reference area. BMJ 1998, 316(7134):818-822.
• [19]Wray RJ, Jupka K, Ludwig-Bell C: A community-wide media campaign to promote walking in a Missouri town. Prev Chronic Dis 2005, 2(4):A04.
• [20]Young DR, Haskell WL, Taylor CB, Fortmann SP: Effect of community health education on physical activity knowledge, attitudes, and behavior. The Stanford Five-City Project. Am J Epidemiol 1996, 144(3):264-274.
• [21]De Cocker KA, De Bourdeaudhuij IM, Brown WJ, Cardon GM: Effects of “10,000 steps Ghent”: a whole-community intervention. Am J Prev Med 2007, 33(6):455-463.
• [22]Baker PR, Francis DP, Soares J, Weightman AL, Foster C: Community wide interventions for increasing physical activity. Cochrane Database Syst Rev 2011., 4CD008366
• [23]Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, Macera CA, Castaneda-Sceppa C: Physical Activity and Public Health in Older Adults. Recommendation From the American College of Sports Medicine and the American Heart Association. Circulation 2007, 116(9):1094-1105.
• [24]Hayden JA, van Tulder MW, Tomlinson G: Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med 2005, 142(9):776-785.
• [25]American Geriatrics Society Panel on Exercise and Osteoarthritis: Exercise prescription for older adults with osteoarthritis pain: consensus practice recommendations. A supplement to the AGS Clinical Practice Guidelines on the management of chronic pain in older adults. J Am Geriatr Soc 2001, 49(6):808-823.
• [26]Roddy E, Zhang W, Doherty M: Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review. Ann Rheum Dis 2005, 64(4):544-548.
• [27]Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, Dougados M, Hochberg M, Hunter DJ, Kwoh K, Lohmander LS, Tugwell P: OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage 2008, 16(2):137-162.
• [28]Woolf AD, Pfleger B: Burden of major musculoskeletal conditions. Bull World Health Organ 2003, 81(9):646-656.
• [29]Japanese Ministry of Health and Welfare: Comprehensive Survey of Living Conditions of the People on Health and Welfare 2007 (in Japanese). http://www.wam.go.jp/wamappl/bb14GS50.nsf/vAdmPBigcategory40/5D7C0BC463105079492574C100019893?OpenDocument webcite
• [30]CDC: Arthritis as a potential barrier to physical activity among adults with heart disease--United States, 2005 and 2007. MMWR Morb Mortal Wkly Rep 2009, 58(7):165-169.
• [31]Campbell MK, Elbourne DR, Altman DG: CONSORT statement: extension to cluster randomised trials. BMJ 2004, 328(7441):702-708.
• [32]American Academy of Orthopaedic Surgeons: Treatment of osteoarthritis of the knee (non-arthroplasty). 2008. http://www.aaos.org/research/guidelines/guidelineoaknee.asp webcite
• [33]Ettinger WH Jr, Burns R, Messier SP, Applegate W, Rejeski WJ, Morgan T, Shumaker S, Berry MJ, O’Toole M, Monu J, Craven T: A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA 1997, 277(1):25-31.
• [34]Kotler P, Lee N: Social maketing: influencing behaviors for good. 3rd edition. Thousand Oaks, CA: Sage; 2008.
• [35]National Social Marketing Centre http://www.nsmcentre.org.uk/ webcite
• [36]CDC: Gateway to Health Communication & Social Marketing Practice. http://www.cdc.gov/healthcommunication/ webcite
• [37]CDC: CDCynergy Social Marketing Edition. http://www.orau.gov/cdcynergy/soc2web/default.htm webcite
• [38]Storey JD, Saffitz GB, Rimon JG: Social marketing. In Health behavior and health education: theory, research, and practice. 4th edition. Edited by Glanz K, Rimer BK, Viswanath K. San Francisco, CA: Jossey-Bass; 2008:435-464.
• [39]Donovan RJ, Egger G, Francas M: TARPARE: a method for selecting target audiences for public health interventions. Aust N Z J Public Health 1999, 23(3):280-284.
• [40]Prochaska JO, DiClemente CC: Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 1983, 51(3):390-395.
• [41]Kamada M, Kitayuguchi J, Shiwaku K, Inoue S, Okada S, Mutoh Y: Differences in association of walking for recreation and for transport with maximum walking speed in an elderly Japanese community population. J Phys Act Health 2011, 8(6):841-847.
• [42]Cavill N, Bauman A: Changing the way people think about health-enhancing physical activity: do mass media campaigns have a role? J Sports Sci 2004, 22(8):771-790.
• [43]Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R, Stave CD, Olkin I, Sirard JR: Using pedometers to increase physical activity and improve health: a systematic review. JAMA 2007, 298(19):2296-2304.
• [44]Boutron I, Guittet L, Estellat C, Moher D, Hrobjartsson A, Ravaud P: Reporting methods of blinding in randomized trials assessing nonpharmacological treatments. PLoS Med 2007, 4(2):e61.
• [45]IPAQ: International Physical Activity Questionnaire. 2008. http://www.ipaq.ki.se/ipaq.htm webcite
• [46]Kumahara H, Schutz Y, Ayabe M, Yoshioka M, Yoshitake Y, Shindo M, Ishii K, Tanaka H: The use of uniaxial accelerometry for the assessment of physical-activity-related energy expenditure: a validation study against whole-body indirect calorimetry. Br J Nutr 2004, 91(2):235-243.
• [47]Rafamantanantsoa HH, Ebine N, Yoshioka M, Higuchi H, Yoshitake Y, Tanaka H, Saitoh S, Jones PJ: Validation of three alternative methods to measure total energy expenditure against the doubly labeled water method for older Japanese men. J Nutr Sci Vitaminol (Tokyo) 2002, 48(6):517-523.
• [48]Dixon JS, Bird HA: Reproducibility along a 10 cm vertical visual analogue scale. Ann Rheum Dis 1981, 40(1):87-89.
• [49]Wijnhoven HA, de Vet HC, Picavet HS: Explaining sex differences in chronic musculoskeletal pain in a general population. Pain 2006, 124(1–2):158-166.
• [50]Sanderson BK, Foushee HR, Bittner V, Cornell CE, Stalker V, Shelton S, Pulley L: Personal, social, and physical environmental correlates of physical activity in rural African-American women in Alabama. Am J Prev Med 2003, 25(3 Suppl 1):30-37.
• [51]Sternfeld B, Ainsworth BE, Quesenberry CP: Physical activity patterns in a diverse population of women. Prev Med 1999, 28(3):313-323.
• [52]Kamada M, Kitayuguchi J, Inoue S, Kamioka H, Mutoh Y, Shiwaku K: Environmental correlates of physical activity in driving and non-driving rural Japanese women. Prev Med 2009, 49(6):490-496.
• [53]Grandes G, Sanchez A, Montoya I, Ortega Sanchez-Pinilla R, Torcal J: Two-year longitudinal analysis of a cluster randomized trial of physical activity promotion by general practitioners. PLoS One 2011, 6(3):e18363.
• [54]Buchbinder R, Jolley D, Wyatt M: Population based intervention to change back pain beliefs and disability: three part evaluation. BMJ 2001, 322(7301):1516-1520.
• [55]Glasgow RE, Vogt TM, Boles SM: Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health 1999, 89(9):1322-1327.
• [56]Sasakawa Sports Foundation: Sports White Paper. Tokyo: Sasakawa Sports Foundation; 2006. in Japanese
• [57]Siegel PZ, Brackbill RM, Heath GW: The epidemiology of walking for exercise: implications for promoting activity among sedentary groups. Am J Public Health 1995, 85(5):706-710.
• [58]Bopp M, Wilcox S, Oberrecht L, Kammermann S, McElmurray CT: Correlates of strength training in older rural African American and Caucasian women. Women Health 2004, 40(1):1-20.
• [59]Reeves MM, Marshall AL, Owen N, Winkler EA, Eakin EG: Measuring physical activity change in broad-reach intervention trials. J Phys Act Health 2010, 7(2):194-202.
• [60]Edwards PJ, Roberts I, Clarke MJ, Diguiseppi C, Wentz R, Kwan I, Cooper R, Felix LM, Pratap S: Methods to increase response to postal and electronic questionnaires. Cochrane Database Syst Rev 2009., 3MR000008
• [61]World Health Organization (WHO): Health Promotion Evaluation: Recommendations to Policymakers. Report of the WHO European Working Group on Health Promotion Evaluation. Copenhagen, Denmark: WHO; 1998.
• [62]Rosen L, Manor O, Engelhard D, Zucker D: In defense of the randomized controlled trial for health promotion research. Am J Public Health 2006, 96(7):1181-1186.