Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial

Area of Science:

• Public Health
• Gerontology
• Behavioral Science

Background:

• Community-wide interventions (CWIs) show limited success in improving population-level physical activity (PA) based on short-term trials.
• Long-term effectiveness of CWIs for promoting PA in middle-aged and older adults remains under investigation.

Purpose of the Study:

• To evaluate the 5-year effectiveness of a CWI for promoting PA in middle-aged and older adults.
• To assess the impact of different PA promotion strategies within a CWI framework.

Main Methods:

• A cluster randomized design involved 12 communities in Unnan, Japan, with 9 in the intervention group and 3 in the control group.
• Residents aged 40-79 years were surveyed at baseline and followed for 5 years, with intervention communities receiving a social marketing-based PA promotion program.
• Intervention communities were subgrouped to promote specific PA types (aerobic, flexibility, muscle-strengthening) or a bundled approach.

Main Results:

• The CWI significantly increased the proportion of adults meeting recommended PA levels by 4.6 percentage points compared to controls.
• Specific PA types, including walking, flexibility, and muscle-strengthening activities, showed significant improvements.
• A bundled approach promoting all PA types simultaneously was not effective; however, awareness of the CWI correlated with PA increases.

Conclusions:

• A 5-year CWI utilizing a focused social marketing strategy successfully enhanced population-level physical activity.
• The findings support the long-term efficacy of targeted community-wide interventions for promoting healthy behaviors in older adults.