title: Do mass media campaigns improve physical activity? a systematic review and meta-analysis.
abstract: BACKGROUND
  Mass media campaigns are frequently used to influence the health behaviors of various populations. There are currently no quantitative meta-analyses of the effect of mass media campaigns on physical activity in adults.
  
  
  METHODS
  We searched six electronic databases from their inception to August 2012 and selected prospective studies that evaluated the effect of mass media campaigns on physical activity in adults. We excluded studies that did not have a proper control group or did not report the uncertainties of the effect estimates. Two reviewers independently screened the title/abstracts and full articles. We used random-effects models to pool effect estimates across studies for 3 selected outcomes.
  
  
  RESULTS
  Nine prospective cohorts and before-after studies that followed-up 27,601 people over 8 weeks to 3 years met the inclusion criteria. Based on the pooled results from these studies, mass media campaigns had a significant effect on promoting moderate intensity walking (pooled relative risk (RR) from 3 studies=1.53, 95% Confidence Interval: 1.25 to 1.87), but did not help participants achieve sufficient levels of physical activity [4 studies pooled RR=1.02, 95% CI: 0.91 to 1.14)]. The apparent effect of media campaigns on reducing sedentary behavior (pooled RR=1.15, 95% CI: 1.03 to 1.30) was lost when a relatively low-quality study with large effects was excluded in a sensitivity analysis. In subgroup analyses, campaigns that promoted physical activity as a 'social norm' seemed to be more effective in reducing sedentary behavior.
  
  
  CONCLUSIONS
  Mass media campaigns may promote walking but may not reduce sedentary behavior or lead to achieving recommended levels of overall physical activity. Further research is warranted on different campaign types and in low- and middle- income countries.
authors.affiliation: Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, Bldg, 1, Room 1107, Boston, MA, USA. gdanaei@hsph.harvard.edu.
authors.forename: Ajibola I
authors.initials: AI
authors.lastname: Abioye
authors.forename: Kaveh
authors.initials: K
authors.lastname: Hajifathalian
authors.forename: Goodarz
authors.initials: G
authors.lastname: Danaei
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