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Prev Med. 2018 Feb;107:61-68. doi: 10.1016/j.ypmed.2017.11.008. Epub 2017 Nov 7.

Community-wide physical activity intervention based on the Japanese physical activity guidelines for adults: A non-randomized controlled trial.

Author information

1
Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa, Kanagawa 252-0883, Japan; Sports Medicine Research Center, Keio University, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa 223-8521, Japan. Electronic address: y.saito@keio.jp.
2
Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa, Kanagawa 252-0883, Japan; Sports Medicine Research Center, Keio University, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa 223-8521, Japan.
3
Fujisawa City Health and Medical Foundation, 5527-1 Oba, Fujisawa, Kanagawa 251-0861, Japan.
4
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 401 Park Drive, 4th floor, Boston, MA 02215, USA; Department of Physical Activity Research, National Institute of Health and Nutrition, NIBIOHN, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan.
5
Department of Preventive Medicine and Public Health, Tokyo Medical University 6-1-1, Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan.
6
Sports Medicine Research Center, Keio University, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa 223-8521, Japan.
7
Sports Medicine Research Center, Keio University, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa 223-8521, Japan; Institute of Physical Education, Keio University, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa 223-8521, Japan.
8
Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa, Kanagawa 252-0883, Japan; Department of Preventive Medicine and Public Health, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
9
Department of Physical Activity Research, National Institute of Health and Nutrition, NIBIOHN, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan.
10
Division of Preventive Medicine, Brigham & Women's Hospital, Harvard Medical School, 900 Commonwealth Ave East, Boston, MA 02215, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.

Abstract

Very few community intervention studies that promote physical activity (PA) using guidelines and its dissemination and implementation have been conducted. Consequently, we evaluated the effectiveness of a community-wide intervention (CWI) of PA with adults based on the Japanese guidelines for promoting PA. This was a non-randomized controlled trial, with four administrative districts in Fujisawa city assigned to the intervention group and nine to the control group. The CWI, conducted from 2013 to 2015, comprised information dissemination, education, and community support. The primary outcome was change in PA participation. Secondary outcomes were CWI awareness and PA guideline knowledge. Outcomes were assessed using questionnaires distributed to two independent, random samples of 3000 community-based adults (aged ≥20years). Two separate samples-1230 adults at baseline and 1393 at the two-year follow-up-responded to the survey. The median time spent in PA did not differ between intervention and control groups after adjusting for potential confounders (adjusted difference between groups=-0.02min/day [95% confidence interval (CI): -0.11, 0.10]). However, intervention group participants were more aware of the CWI (33.8%) than were control group participants (25.2%) at the two-year follow-up (odds ratio=1.44 [95% CI: 1.06, 1.95]). A significant difference was also observed in participants' PA guideline knowledge (adjusted difference between groups=0.82% [95% CI: 0.33, 1.31]). Although significant differences in awareness and knowledge were observed between groups, this CWI did not change PA levels over two years. Future studies should investigate the long-term effects of CWIs beyond two years.

TRIAL REGISTRATION NUMBER:

UMIN-CTR UMIN000018389.

KEYWORDS:

Community intervention study; Dissemination; Exercise; Health communication; Implementation; Population strategy

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