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Methods of Promoting PA Systematic Review SUE 07

Methods of Promoting PA Systematic Review SUE 07

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Methods of PromotingPhysical Activity
A Systematic Review
Methods of PromotingPhysical Activity
This is a summary of SBU’s systematicreview of the literature concerning methodsof promoting physical activity. The reportis not about how physical activity correlateswith health, but the effectiveness of variousmethods of promoting it.The summary and Conclusions of thereport, presented in the booklet, have beenapproved by the SBU Board of Directorsand the Scientific Advisory Committee.
Summary and Conclusions
The Swedish Council on Technology Assessment in Health Care
SBU, Box 5650,
SE
-114 86 Stockholm, SwedenStreet Address: Tyrgatan 7Telephone: +46-8-412 32 00Fax: +46-8-411 32 60www.sbu.seE-mail: info@sbu.se
 
 AnnA EngStröm-LAurEnt
Swedish Society of Medicine 
 Ann HEdbErg bALkå
The Swedish Associationof Local Authorities 
SvEn-OLOf kArLSSOn
The Swedish Associationof Local Authorities 
björn kLingE
Karolinska Institute
Secretariat
månS rOSén
Executive Director, SBU
Board of Directors
ninA rEHnqviSt
Karolinska Institute(Chair)
HåkAn biLLig
Swedish Research Council 
HåkAn CEdEr
The National Board of Health and Welfare 
 AnnA-kArin EkLund
Swedish Association of Health Professionals
Scientific Advisory Committee
dAvid bErgqviSt
Uppsala University Hospital(Chair) 
 AndErS AnELL
The Swedish Insitute forHealth Economics, Lund 
björn bEErmAnn
Medical Products Agency,Uppsala  
CECiLiA björkELund
Göteborgs University  
LiSA EkSELiuS
Uppsala University 
EvA niLSSOn bågEnHOLm
The Swedish Medical Association 
HåkAn SörmAn
The Swedish Associationof Local Authorities 
gunnAr ågrEn
The Swedish NationalInstitute of Public Health
mAtS ELiASSOn
Sunderby Hospital, Luleå  
SöLvE ELmStåHL
University Hospital, Malmö 
mikAEL HELLStröm
Sahlgrenska Hospital,Göteborg  
 AndErS LindgrEn
The Swedish Ministry of Health and Social Affairs 
kErStin niLSSOn
University Hospital, Örebro 
OLOf nyrén
Karolinska Institute,Solna  
 jAn PALmbLAd
Karolinska Institute,Huddinge 
björn SjöStröm
University of Skövde 
gunnEvi SundELin
Umeå University  
gunnEL SvEnSätEr
Malmö University 
SBU Board of Directors andScientific Advisory Committee
Ken Schubert
English Translation:Project Group:
Mai-Lis Hellénius(Chair) Viveka Alton(Assistant ProjectDirector)Ingemar Eckerlund(Project Director)
Scientific Reviewers:
Sigmund AnderssenNils-Holger Areskog Lars-Magnus EngströmKarin Harms-RingdahlSusanne Eksell(Project Assistant)Margareta EmtnerLars Hagberg Margareta JohanssonLena KallingsBernt LindahlHans Lingfors Agneta StåhleBerit Mørland(Observer)Ivar S KristiansenKatriina Kukkonen-Harjula 
Co-authors
Niels LynöeMatti Leijon
Summary and Conclusions of the SBU Report on:
Methods of PromotingPhysical Activity
A Systematic ReviewMarch 2007
Report: Methods of Promotg Physcal Actvty • Type: Systematc Revew iSbn: 978-91-85413-12-6 • iSSn: 1400-1403Report o: 181 • Pulshg year: 2007 
 
SBU SUmmary and ConClUSionSFrom the report methodS oF promoting phySiCal aCtivity
  c  o  n  c   l  u  s   i  o  n  s
Theory-Based Behavioural Intervention
q
Theory-based behavioural intervention increases physicalactivity 10–15% more than usual care and as much as struc-tured exercise programs (Evidence Grade
3
).
q
More extensive behavioural interventions further boost phys-ical activity, though with a diminishing marginal effect(Evidence Grade
3
).
q
Interventions that include a person’s entire lifestyle, focusing on diet and stress management as well as physical activity,reinforce the increase in activity (Evidence Grade
3
).
Methods for Children and Adolescents
q
Devoting greater resources to school curricula in areas such ashealth education, textbooks, study materials and teacher train-ing increases activity by 5–25% during physical education clas-ses – even more so for boys than for girls. (Evidence Grade
1
).
q
School-based interventions that include multiple components– such as teacher training, curriculum modifications, extra activity sessions during class periods and/or recess, support forbehaviour changes, improved health education and the involve-ment of parents – favourably impact the physical activity of children and adolescents during the school day and sometimesduring after-school hours and weekends as well (EvidenceGrade
2
).
q
School-based interventions for groups at greater risk of cardio-vascular disease increase physical activity by approximately 10%.(Evidence Grade
3
).
Following is a summary of SBU’s systematic review of the literat-ure concerning 
methods of promoting physical activity 
. This reportis
not 
about how physical activity correlates with health, but theeffectiveness of various methods of promoting it.
SBU’s Conclusions
Advice and Counselling
q
Advice and counselling of patients in everyday clinical practiceincreases physical activity by 12–50% for at least six monthsafter the counselling session (Evidence Grade
1
).
q
More frequent, intensive counselling by means of repeatedsessions for several months additionally boosts physical activity (Evidence Grade
3
).
q
Counselling supplemented by prescribed physical activity,diaries, pedometers, informational brochures, etc, increasesactivity by another 15–50% (Evidence Grade
3
).
 Supervised Exercise in Group and Individualized Programs
q
A six-month group exercise program for patients with coronary artery disease promotes physical activity (Evidence Grade
3
).
q
A six-month supervised exercise program for patients withperipheral arterial disease increases physical activity in termsof walking distance and/or time (Evidence Grade
3
).

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