The role of a new Cochrane systematic review examining community-wide interventions to increase physical activity

Article type
Authors
Baker P1, Francis D1
1Queensland University of Technology and Queensland Health
Abstract
Objectives: We sought to compare a new Cochrane review of community-wide strategies to increase population levels of physical activity to an earlier Community Guide Review (CGR) of Community-wide campaigns to increase physical activity which recommended community wide interventions.

Methods: We recently completed the Cochrane review of Community-wide interventions to increase physical activity. We compared the definitions, design and findings of the CSR to the CGR.

Results: There were substantial differences in the conclusions of the two reviews. The CGR found ‘strong evidence exists that community-wide campaigns are effective in increasing levels of physical activity’, while the new CSR stated that ‘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’. Both reviews examined multi-component interventions. Possible explanations for the different conclusions include different definitions of community (CSR defined community as comprising those persons residing in a geographically defined community, e.g. a village, town, or city, excluding interventions which were whole of state or country, and CGR as a group of individuals who share one or more characteristics). The CSR utilised a logic model and explicitly defined a combination of strategies encompassed within the intervention. The CSR included 25 and CGR 10 studies, respectively. Six of the 10 studies that were included in CGR were excluded from the CSR due to issues relating to study design, intervention/community definition, or duration.

Conclusions: Differences in the findings between older and newer reviews of similar topics can be due to a variety of factors including: (1) an updated definition of the intervention, (2) improvements in the standards and methodologies for systematic reviews and (3) the inclusion of newer studies. These factors need to be understood whenever differences between newer and older public health reviews are considered.