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The effectiveness of interventions on sustained childhood physical activity: a systematic review and meta-analysis of controlled studies |
Sims J, Scarborough P, Foster C |
PLoS ONE 2015 Jul;10(7):e0132935 |
systematic review |
BACKGROUND: Increased physical activity (PA) has been associated with a reduction in non-communicable disease risk factors and outcomes. However, interventions to increase childhood PA typically produce small to negligible effects. Recent reviews are limited due to lack of post-intervention follow-up measurement. This review aimed to examine measured effects at least six months post-intervention. METHODS AND FINDINGS: We searched PubMed, Medline, Embase, PsycINFO, ScienceDirect, SPORTDiscus and Google Scholar between 1st January 1991 and 1st November 2014 for controlled studies reporting six-month post-intervention measurement for children aged 5 to 18 years. 14 studies met inclusion criteria; 12 reported moderate-to-vigorous PA (MVPA) (n = 5,790) and 10 reported total PA (TPA) (n = 4,855). We calculated overall effect estimates and 95% CI's using random effects modelling with inverse variance weighting. Mean difference was calculated for MVPA, with standardised mean difference calculated to TPA due to measurement variation. Meta-regression assessed heterogeneity by continuous level variables. Negligible mean difference in MVPA existed in favour of the intervention group, amounting to 1.47 (95% CI -1.88 to 4.82) mins/day compared to controls, while no difference was recorded on TPA. Sub-group analyses revealed males (2.65 mins/day: 95% CI 2.03 to 3.27) reported higher levels of MVPA than females (-0.42 mins/day: 95% CI -7.77 to 6.94), community settings (2.67 mins/day: 95% CI 2.05, 3.28) were more effective than school settings (1.70 mins/day: 95% CI -4.84 to 8.25), and that treatment (4.47 mins/day: 95% CI -0.81 to 9.76) demonstrated greater effects than population approaches (1.03 mins/day: 95% CI -2.54 to 4.60). Meta-regression revealed no significant differences by factor on pooled effects. Significant heterogeneity existed between studies and potential for small study effects was present. CONCLUSIONS: Improved PA levels subsequent to intervention were not maintained six month post-intervention. A potentially useful avenue of future research is to specifically explore community treatment of high risk individuals. REVIEW REGISTRATION: PROSPERO CRD42014007545.
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