Changing Physical activity behavior in people with multiple sclerosis: a systematic review and meta-analysis

Objectives To (1) systematically review the literature on behavioral interventions for people with multiple sclerosis (MS) that aim to change physical activity (PA) behavior; and (2) explore whether these interventions are clinically effective in improving PA, are theory based, and use established behavior change techniques (BCTs). Data Sources A systematic electronic search was conducted on databases EBSCO (including AMED, Biomedical Reference Collection: Expanded, CINHAL, MEDLINE, PsycArticles, PsycInfo), PubMed, EMBASE, and Web of Science from April 2017 to May 2017. Study Selection Studies were included if (1) the interventions aimed to change PA behavior among people with MS; (2) PA was recognized as a primary outcome measure; and (3) they had a randomized controlled trial (RCT) design. Data Extraction The resulting behavioral interventions were coded using the Theory Coding Scheme and the CALO-RE taxonomy to assess theory base and BCTs. A meta-analysis was conducted to assess effectiveness Data Synthesis Fourteen RCTs were included. Combined, there was a significant (P=.0003; d=1.00; 95% confidence interval, .46–1.53) short-term change in self-report PA behavior for studies with nonactive control groups. There was no change in objective or long-term PA. Studies failed to discuss results in relation to theory and did not attempt to refine theory. Fifty percent of BCTs within the CALO-RE were used, with BCTs of “goal-setting” and “action-planning” being the most frequently used. Conclusions Current evidence supports the efficacy of PA intervention on subjective but not objective outcomes. However, conclusions from this review should be interpreted with caution because of the small number of studies included and small sample size. Further, while using theory in intervention design, interventions in this review have not reported the refining of theory. Exploration of the use of additional BCTs to change PA behavior is also required within future interventions

Evidence of the impact of sport policies on physical activity and sport participation: a systematic mixed studies review

Participation in sport contributes to increased physical activity (PA) levels. Increasing PA is a public health concern due to its recognised impact on health outcomes. International policy actors such as the Council of Europe, the World Health Organisation (WHO) and the International Society for Physical Activity and Health (ISPAH) have recommended that ‘sport for all’ is promoted both for public health and as a basic right. This review aims to evaluate sport related policies aimed at maximising the opportunity to participate in PA and sporting activity. Six electronic Participation in sport contributes to increased physical activity (PA) levels. Increasing PA is a public health concern due to its recognised impact on health outcomes. International policy actors such as the Council of Europe, the World Health Organisation (WHO) and the International Society for Physical Activity and Health (ISPAH) have recommended that ‘sport for all’ is promoted both for public health and as a basic right. This review aims to evaluate sport related policies aimed at maximising the opportunity to participate in PA and sporting activity. Six electronic databases were systematically searched for quantitative, qualitative and review studies investigating how public sport policy affects PA outcomes. The scientific literature was screened according to predetermined eligibility criteria. Following study selection and data extraction, the quality was assessed using modified versions of existing quality assessment tools. Results were synthesised and the context in which policy actions occurred analysed using the Context and Implementation of Complex Interventions (CICI) framework. Database searches identified 3705 unique articles. A total of 93 full-text articles were assessed, with 22 meeting our inclusion criteria. Seven unique ‘policy actions’ were identified and were categorised into the ‘policy areas’ facilities, Financial, Collaboration and Exhortation. Policy actions to promote PA and sport participation have demonstrated qualified success but there is limited evidence of success in engaging hard to reach groups. Therefore, policymakers utilising sport to increase PA should treat it as a complementary intervention alongside other policy actions based on a systems perspective. databases were systematically searched for quantitative, qualitative and review studies investigating how public sport policy affects PA outcomes. The scientific literature was screened according to predetermined eligibility criteria. Following study selection and data extraction, the quality was assessed using modified versions of existing quality assessment tools. Results were synthesised and the context in which policy actions occurred analysed using the Context and Implementation of Complex Interventions (CICI) framework. Database searches identified 3705 unique articles. A total of 93 full-text articles were assessed, with 22 meeting our inclusion criteria. Seven unique ‘policy actions’ were identified and were categorised into the ‘policy areas’ Facilities, Financial, Collaboration and Exhortation. Policy actions to promote PA and sport participation have demonstrated qualified success but there is limited evidence of success in engaging hard to reach groups. Therefore, policymakers utilising sport to increase PA should treat it as a complementary intervention alongside other policy actions based on a systems perspective.</p