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Int J Behav Nutr Phys Act. 2015 Jun 23;12:82. doi: 10.1186/s12966-015-0242-0.

Community-wide promotion of physical activity in middle-aged and older Japanese: a 3-year evaluation of a cluster randomized trial.

Author information

1
Department of Health Promotion and Exercise, National Institute of Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan. kamada@gakushikai.jp.
2
Division of Preventive Medicine, Brigham & Women's Hospital, Harvard Medical School, 900 Commonwealth Ave East, Boston, MA, 02215, USA. kamada@gakushikai.jp.
3
Physical Education and Medicine Research Center UNNAN, 1212-3 Mitoya, Mitoya-cho, Unnan, Shimane, 690-2404, Japan. kamada@gakushikai.jp.
4
Physical Education and Medicine Research Center UNNAN, 1212-3 Mitoya, Mitoya-cho, Unnan, Shimane, 690-2404, Japan. junk_907@yahoo.co.jp.
5
Physical Education and Medicine Research Center UNNAN, 1212-3 Mitoya, Mitoya-cho, Unnan, Shimane, 690-2404, Japan. fussball527@yahoo.co.jp.
6
Department of Biostatistics and Epidemiology, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan. taguri@yokohama-cu.ac.jp.
7
Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan. inoue@tokyo-med.ac.jp.
8
Department of Health and Social Behavior, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. ishikun51@hotmail.com.
9
Department of Functioning Activation, National Centre for Geriatrics and Gerontology, 7-430 Morioka-machi, Obu, Aichi, 474-8511, Japan. haradak@ncgg.go.jp.
10
Division of Preventive Medicine, Brigham & Women's Hospital, Harvard Medical School, 900 Commonwealth Ave East, Boston, MA, 02215, USA. ilee@rics.bwh.harvard.edu.
11
Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA. ilee@rics.bwh.harvard.edu.
12
School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia. adrian.bauman@sydney.edu.au.
13
Department of Health Promotion and Exercise, National Institute of Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan. miyachi@nih.go.jp.

Abstract

BACKGROUND:

Promotion of physical activity (PA) is a key strategy to prevent non-communicable diseases. However, evidence on the effectiveness of community-wide interventions (CWIs) for promoting PA is limited.

PURPOSE:

To evaluate the effectiveness of a 3-year CWI for promoting PA in middle-aged and older adults compared with usual public health services. This study is an extension to an original 1-year investigation study.

DESIGN:

Cluster randomized controlled trial with community as unit of randomization and individual as unit of analysis.

SETTING/PARTICIPANTS:

12 communities in Unnan, Japan were randomly allocated to the intervention (9) or the control (3). Additionally intervention communities were randomly allocated to aerobic activity promotion (Group A), flexibility and muscle-strengthening activities promotion (Group FM), or aerobic, flexibility, and muscle-strengthening activities promotion (Group AFM), each consisting of three communities. Randomly-sampled 4414 residents aged 40 to 79 years responded to the baseline survey (74%), and were analyzed in 2013-2014.

INTERVENTION:

A 3-year CWI based on social marketing, to promote PA from 2009 to 2012.

MAIN OUTCOME MEASURES:

The primary outcome was a change in regular aerobic, flexibility, and/or muscle-strengthening activities, defined by (1) engaging in 150 mins/week or more of walking, (2) engaging in daily flexibility activity, or (3) engaging 2 or more days/week in muscle-strengthening activities, evaluated at the individual level. Secondary outcomes were changes in specific types of PA and musculoskeletal pain. Outcomes were measured at baseline and at 1 and 3 years (2009, 2010, and 2012).

RESULTS:

The CWI did not significantly increase the proportion of adults who reached recommended levels of aerobic, flexibility, and/or muscle-strengthening activities (adjusted change difference = 1.6% [95% CI: -3.5, 6.6]). In the subgroup analysis, compared to the controls, adults doing flexibility activity daily significantly increased in Group FM (6.3% [95% CI: 1.9, 10.7]). In Group A and AFM for PA outcomes and in all groups for pain outcomes, there was no significant change compared to controls.

CONCLUSIONS:

The CWI did not achieve significant increase in the proportion of adults who reached recommended PA levels. However, it might be effective in promoting flexibility activity in middle-aged and older Japanese.

TRIAL REGISTRATION:

UMIN-CTR UMIN000002683 .

PMID:
26100607
PMCID:
PMC4484628
DOI:
10.1186/s12966-015-0242-0
[Indexed for MEDLINE]
Free PMC Article

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