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Systematic Review
The authors state:
"This systematic review aimed to evaluate the effects of community wide, multi‐strategic interventions upon population levels of physical activity."
The authors state:
"33 studies were included. A total of 267 communities were included in the review (populations between 500 and 1.9 million). Of the included studies, 25 were set in high income countries and eight were in low income countries. The interventions varied by the number of strategies included and their intensity. Almost all of the interventions included a component of building partnerships with local governments or non‐governmental organisations (NGOs) (29 studies). Nineteen studies were identified as having a high risk of bias, 10 studies were unclear, and four studies had a low risk of bias. Generally, the better designed studies showed no improvement in the primary outcome measure of physical activity at a population level.
One study obtained objective population representative measurements of physical activity by accelerometers, while the remaining three low‐risk studies used validated self‐reported measures. The study using accelerometry, conducted in low income, high crime communities of USA, emphasised social marketing, partnership with police and environmental improvements. No change in the seven‐day average daily minutes of moderate to vigorous physical activity was observed during the two years of operation. Some program level effect was observed with more people walking in the intervention community, however this result was not evident in the whole community. Similarly, the two studies conducted in the United Kingdom (one in rural villages and the other in urban London; both using communication, partnership and environmental strategies) found no improvement in the mean levels of energy expenditure per person per week, measured from one to four years from baseline.
Overall, there was a noticeable absence of reporting of benefit in physical activity for community wide interventions in the included studies."
The authors state:
"Although numerous studies have been undertaken, there is a noticeable inconsistency of the findings in the available studies and this is confounded by serious methodological issues within the included studies. The body of evidence in this review does not support the hypothesis that the multi-component community wide interventions studied effectively increased physical activity for the population, although some studies with environmental components observed more people walking."