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- bmj.39198.722720.BEv1
- 334/7605/1204 most recent
- David Ogilvie, MRC fellow1,
- Charles E Foster, senior researcher2,
- Helen Rothnie, research associate3,
- Nick Cavill, research associate2,
- Val Hamilton, research assistant4,
- Claire F Fitzsimons, SPARColl project coordinator3,
- Nanette Mutrie, professor of exercise and sport psychology3
- on behalf of the Scottish Physical Activity Research Collaboration (SPARColl)
- 1Medical Research Council Social and Public Health Sciences Unit, Glasgow G12 8RZ
- 2British Heart Foundation Health Promotion Research Group, University of Oxford, Oxford
- 3Department of Sport, Culture and the Arts, University of Strathclyde, Glasgow
- 4Development and Alumni Office, University of Glasgow, Glasgow
- Correspondence to: D Ogilvie d.ogilvie{at}msoc.mrc.gla.ac.uk
- Accepted 1 April 2007
Abstract
Objective To assess the effects of interventions to promote walking in individuals and populations.
Design Systematic review.
Data sources Published and unpublished reports in any language identified by searching 25 electronic databases, by searching websites, reference lists, and existing systematic reviews, and by contacting experts.
Review methods Systematic search for and appraisal of controlled before and after studies of the effects of any type of intervention on how much people walk, the distribution of effects on walking between social groups, and any associated effects on overall physical activity, fitness, risk factors for disease, health, and wellbeing.
Results We included 19 randomised controlled trials and 29 non-randomised controlled studies. Interventions tailored to people's needs, targeted at the most sedentary or at those most motivated to change, and delivered either at the level of the individual (brief advice, supported use of pedometers, telecommunications) or household (individualised marketing) or through groups, can encourage people to walk more, although the sustainability, generalisability, and clinical benefits of many of these approaches are uncertain. Evidence for the effectiveness of interventions applied to workplaces, schools, communities, or areas typically depends on isolated studies or subgroup analysis.
Conclusions The most successful interventions could increase walking among targeted participants by up to 30-60 minutes a week on average, at least in the short term. From a perspective of improving population health, much of the research currently provides evidence of efficacy rather than effectiveness. Nevertheless, interventions to promote walking could contribute substantially towards increasing the activity levels of the most sedentary.
Footnotes
We thank the Centre for Reviews and Dissemination at the University of York for executing parts of our search strategy; authors and experts who contributed information about studies considered for inclusion in the review; and Mark Petticrew for advice and comments on the draft manuscript.
Contributors: DO led the review on behalf of the Scottish Physical Activity Research Collaboration (http://sparcoll.org.uk: NM, Fiona Bull, CEF, Jo Inchley, Myra Nimmo, DO, and Catharine Ward Thompson) and with the support of SPARColl's international reviewers (Adrian Bauman, Billie Giles-Corti, Sally Macintyre, Pekka Oja, and James Sallis) and steering group. VH, DO, CEF, and NM designed the search strategy, parts of which were executed by DO and CEF. VH, HR, DO, and NC screened the initial results of the literature searches. HR, DO, NC, CFF, and CEF appraised and extracted data from primary studies and analysed the findings. DO and HR drafted the manuscript. All authors contributed to the critical revision of the manuscript and approved the final version. DO is guarantor.
Funding: The Scottish Physical Activity Research Collaboration (SPARColl) is managed by NHS Health Scotland and funded by the Scottish Executive Health Department. DO is funded by a Medical Research Council fellowship.
Competing interests: NC sells pedometers in his capacity as a health promotion consultant. NM is an author of three of the primary studies included in the systematic review but played no part in the appraisal of those studies for the review.
Ethical approval: Not required.
- Accepted 1 April 2007
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