Effectiveness of Primary Care-Based Interventions Promoting Physical Activity: A Meta-Analysis Study

Öz

The benefits of physical activity in promoting health and preventing chronic diseases have been proven; however, inactivity remains a major problem in many countries worldwide. This meta-analysis aimed to evaluate the effectiveness of primary care-based interventions for physical activity promotion. The literature search was carried out on Medline, Cochrane Library, Web of Science, and Scopus databases. Randomized controlled studies performed on adults, included interventions for promoting physical activity, had a follow-up period of at least 12 months, and performed intention-to-treat analysis were reviewed. A total of 16 randomized controlled trials from 7 different countries were included in the meta-analysis (n=8,762). The most common interventions were providing informative materials about physical activity (10 studies), phone calls for support and follow-up (10 studies), and providing an exercise prescription/program for the participants (9 studies). In five studies, participants were given self-monitoring tools to follow up on their own activity levels. Interventions provided low or low-medium increases in the physical activity duration (standardized mean difference [SMD]=0.21, 95.0% CI: 0.15 – 0.27), energy spent on physical activities (SMD=0.14, 95.0% CI: 0.05 – 0.23), and the number of steps (SMD=0.32, 95.0% CI: 0.19 – 0.44). Although interventions aimed to increase the physical activity level showed limited effectiveness, given the strong health benefits of physical activity, promotion programs in this regard need to be integrated into primary health care.

Anahtar Kelimeler

• Primary health care
• Exercise
• Physical activity
• Meta-analysis

Fiziksel Aktiviteyi Teşvik Eden Birinci Basamak Temelli Müdahalelerin Etkililiği: Bir Meta-Analiz Çalışması

Öz

Fiziksel aktivitenin sağlığı geliştirme ve kronik hastalıkları önleme konusundaki faydaları kanıtlanmış olmasına karşın hareketsizlik dünyanın birçok ülkesinde önemli bir sorun olmaya devam etmektedir. Bu meta-analizde, fiziksel aktiviteyi teşvik etmek için yapılan birinci basamak temelli müdahalelerin etkililiğinin değerlendirilmesi amaçlanmıştır. Literatür taraması Medline, Cochrane Library, Web of Science ve Scopus veri tabanlarında yapılmıştır. Yetişkinler üzerinde gerçekleştirilen, fiziksel aktiviteyi teşvik etmeye yönelik müdahaleleri içeren, takip süresi en az 12 ay olan ve intention-to-treat analizi yapılan randomize kontrollü çalışmalar gözden geçirilmiştir. Yedi farklı ülkeden toplam 16 randomize kontrollü çalışma meta-analize dahil edilmiştir (n=8,762). En yaygın müdahaleler, fiziksel aktivite hakkında bilgilendirici materyallerin sağlanması (10 çalışma), destek ve takip için telefon görüşmeleri yapılması (10 çalışma) ve katılımcılar için egzersiz reçetesi/programı hazırlanmasıdır (9 çalışma). Beş çalışmada, katılımcılara kendi etkinlik düzeylerini görebilmeleri için aktivite takip araçları verilmiştir. Müdahaleler; fiziksel aktivite süresi (standartlaştırılmış ortalama fark [SMD]=0,21, %95,0 GA: 0,15 – 0,27), fiziksel aktiviteler için harcanan enerji (SMD=0,14, %95,0 GA: 0,05 – 0,23) ve adım sayısı (SMD=0,32, %95,0 GA: 0,19 – 0,44) düzeyleri üzerinde küçük veya küçük-orta düzeyde artış sağlamıştır. Fiziksel aktivite düzeyini artırmaya yönelik müdahalelerin sınırlı etkililik göstermiş olmalarına karşın, fiziksel aktivitenin güçlü sağlık yararları göz önüne alındığında, bu konudaki teşvik programlarının birinci basamak sağlık hizmetlerine entegre edilmesi gerekmektedir.

Anahtar Kelimeler

• Birinci basamak sağlık hizmeti
• egzersiz
• fiziksel aktivite
• meta analiz

Kaynakça

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