activity intervention approaches, Only studies with a minimum programme or effect intensity of actions delivered, follow up from the start of a co-ordinated interventions the outcomes assessed and the intervention to measurement approach OR is Cochrane comparison communities. The of outcomes were included. implementation overall quality of the studies Community wide interventions had nationally on an Database of was poor with the majority to comprise at least two broad ad-hoc basis Systematic assessed as having a high risk strategies aimed at physical Reviews of bias. There is a noticeable activity for the whole population. inconsistency of the findings of Studies which randomised the available studies. The body individuals from the same of evidence in this review does community were excluded. Fifteen not support the hypothesis that studies were identified as having a multi-component community high risk of bias, 10 studies were wide interventions effectively unclear, and no studies had a low increase population levels of risk of bias. Selection bias physical activity. It could be was a major concern with these postulated that, given the studies, with only one study using conflicting findings, community randomisation to allocate wide interventions lack efficacy, communities. 11 studies were at however we believe such a high risk of detection bias. conclusion would be premature Almost all of the interventions given the poor quality of studies by included articles studies. In particular, the tools involved building partnerships with used to measure physical local governments or activity were generally weak, nongovernment organisations inhibiting the ability to interpret (NGOs) (22 studies). Others the results and draw included some form of individual conclusions. counselling by health professionals (18 studies), mass media There is a clear need for campaigns (17 studies), or other intervention studies communication strategies (19 and such studies should focus studies). Some studies worked in on the quality of the specific settings (21 studies) and measurement of physical used environmental change
activity interventions Cochrane Database of Systematic Reviews intervention approaches, intensity of actions delivered, the outcomes assessed and comparison communities. The overall quality of the studies was poor with the majority assessed as having a high risk of bias. There is a noticeable inconsistency of the findings of the available studies. The body of evidence in this review does not support the hypothesis that multi-component community wide interventions effectively increase population levels of physical activity. It could be postulated that, given the conflicting findings, community wide interventions lack efficacy, however we believe such a conclusion would be premature given the poor quality of studies. In particular, the tools used to measure physical activity were generally weak, inhibiting the ability to interpret the results and draw conclusions. There is a clear need for intervention studies and such studies should focus on the quality of the measurement of physical Only studies with a minimum follow up from the start of the intervention to measurement of outcomes were included. Community wide interventions had to comprise at least two broad strategies aimed at physical activity for the whole population. Studies which randomised individuals from the same community were excluded. Fifteen studies were identified as having a high risk of bias, 10 studies were unclear, and no studies had a low risk of bias. Selection bias was a major concern with these studies, with only one study using randomisation to allocate communities. 11 studies were at high risk of detection bias. Almost all of the interventions studies by included articles involved building partnerships with local governments or nongovernment organisations (NGOs) (22 studies). Others included some form of individual counselling by health professionals (18 studies), mass media campaigns (17 studies), or other communication strategies (19 studies). Some studies worked in specific settings (21 studies) and used environmental change programme or a co-ordinated approach OR is implementation nationally on an ad-hoc basis effect
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