title: Theory-based behavioral intervention increases self-reported physical activity in South African men: a cluster-randomized controlled trial.
abstract: OBJECTIVE
  To determine whether a health-promotion intervention increases South African men's adherence to physical-activity guidelines.
  
  
  METHODS
  We utilized a cluster-randomized controlled trial design. Eligible clusters, residential neighborhoods near East London, South Africa, were matched in pairs. Within randomly selected pairs, neighborhoods were randomized to theory-based, culturally congruent health-promotion intervention encouraging physical activity or attention-matched HIV/STI risk-reduction control intervention. Men residing in the neighborhoods and reporting coitus in the previous 3 months were eligible. Primary outcome was self-reported individual-level adherence to physical-activity guidelines averaged over 6-month and 12-month post-intervention assessments. Data were collected in 2007-2010. Data collectors, but not facilitators or participants, were blind to group assignment.
  
  
  RESULTS
  Primary outcome intention-to-treat analysis included 22 of 22 clusters and 537 of 572 men in the health-promotion intervention and 22 of 22 clusters and 569 of 609 men in the attention-control intervention. Model-estimated probability of meeting physical-activity guidelines was 51.0% in the health-promotion intervention and 44.7% in attention-matched control (OR=1.34; 95% CI, 1.09-1.63), adjusting for baseline prevalence and clustering from 44 neighborhoods.
  
  
  CONCLUSIONS
  A theory-based culturally congruent intervention increased South African men's self-reported physical activity, a key contributor to deaths from non-communicable diseases in South Africa.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT01490359.
authors.affiliation: University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA; University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, USA. Electronic address: jjemmott@asc.upenn.edu.
authors.forename: John B
authors.initials: JB
authors.lastname: Jemmott
authors.affiliation: University of Pennsylvania, School of Nursing, Philadelphia, PA, USA.
authors.forename: Loretta S
authors.initials: LS
authors.lastname: Jemmott
authors.affiliation: Haverford College, Department of Anthropology, Haverford, PA, USA.
authors.forename: Zolani
authors.initials: Z
authors.lastname: Ngwane
authors.affiliation: University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, USA.
authors.forename: Jingwen
authors.initials: J
authors.lastname: Zhang
authors.affiliation: University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA.
authors.forename: G Anita
authors.initials: GA
authors.lastname: Heeren
authors.affiliation: Temple University, College of Health Professions and Social Work, Philadelphia, PA, USA.
authors.forename: Larry D
authors.initials: LD
authors.lastname: Icard
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: O'Leary
authors.affiliation: University of Fort Hare, Faculty of Education, East London, South Africa.
authors.forename: Xoliswa
authors.initials: X
authors.lastname: Mtose
authors.affiliation: University of Pennsylvania, School of Nursing, Philadelphia, PA, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Teitelman
authors.affiliation: University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Carty
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People; D016000:Cluster Analysis; D054521:Cultural Competency; D004032:Diet / Q000592:standards*; D005638:Fruit; D019983:Guideline Adherence / Q000706:statistics & numerical data; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D015438:Health Behavior / Q000208:ethnology*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D040242:Risk Reduction Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D066269:Social Theory; D013019:South Africa; D014675:Vegetables; D055815:Young Adult
keywords: Binge drinking; Fruits and vegetables; Intervention study; Men; Physical activity; Randomized controlled trial; Social cognitive theory; South Africa; Theory of planned behavior
references.citation: Am J Public Health. 1999 Sep;89(9):1390-6
references.pmid: 10474558
references.citation: Cochrane Database Syst Rev. 2013 Sep 30;9:CD010395
references.pmid: 24085594
references.citation: Vascular. 2011 Dec;19(6):301-7
references.pmid: 21940758
references.citation: Vital Health Stat 10. 2012 Dec;(256):1-218
references.pmid: 25116400
references.citation: Am J Public Health. 1995 Dec;85(12):1623-9
references.pmid: 7503335
references.citation: Lancet. 2011 Oct 1;378(9798):1244-53
references.pmid: 21846575
references.citation: Diabetes Care. 2012 Sep;35(9):1876-83
references.pmid: 22751959
references.citation: Stroke. 2003 Oct;34(10):2475-81
references.pmid: 14500932
references.citation: Br J Gen Pract. 2011 Mar;61(584):e125-33
references.pmid: 21375895
references.citation: Breast Cancer Res Treat. 2013 Feb;137(3):869-82
references.pmid: 23274845
references.citation: Lancet. 2012 Jul 21;380(9838):272-81
references.pmid: 22818939
references.citation: Trop Med Int Health. 2010 Mar;15(3):362-81
references.pmid: 20409291
references.citation: JAMA. 1984 Oct 12;252(14):1905-7
references.pmid: 6471323
references.citation: Ethn Dis. 2007 Autumn;17(4):749-54
references.pmid: 18072390
references.citation: Soc Sci Med. 2007 Jul;65(2):296-308
references.pmid: 17475382
references.citation: Prev Sci. 2008 Mar;9(1):55-62
references.pmid: 18264762
references.citation: Prev Med. 2008 Oct;47(4):354-68
references.pmid: 18675845
references.citation: Lancet. 2012 Jul 21;380(9838):219-29
references.pmid: 22818936
references.citation: Psychol Health. 2011 Feb;26(2):167-85
references.pmid: 21318928
references.citation: BMC Public Health. 2012 Oct 17;12:880
references.pmid: 23075000
references.citation: S Afr Med J. 2009 Sep;99(9):661-7
references.pmid: 20073293
references.citation: Lancet. 2006 Dec 2;368(9551):1973-83
references.pmid: 17141704
references.citation: Diabetes Care. 2012 Dec;35(12):2681-9
references.pmid: 23173137
references.citation: J Natl Cancer Inst. 2012 Oct 17;104(20):1548-61
references.pmid: 22914790
references.citation: Arch Intern Med. 2011 Apr 25;171(8):728-36
references.pmid: 21518939
references.citation: Am J Public Health. 2014 Mar;104(3):467-73
references.pmid: 24432923
references.citation: S Afr Med J. 2007 Aug;97(8 Pt 2):725-31
references.pmid: 17952230
references.citation: Lancet. 2012 Jul 21;380(9838):247-57
references.pmid: 22818937
references.citation: BMC Public Health. 2013 Jan 11;13:25
references.pmid: 23311458
references.citation: Int J Epidemiol. 2011 Oct;40(5):1382-400
references.pmid: 22039197
references.citation: J Phys Act Health. 2011 Jan;8(1):85-103
references.pmid: 21297189
references.citation: Lancet. 2009 Sep 12;374(9693):934-47
references.pmid: 19709736
references.citation: Lancet. 2012 Dec 8;380(9858):2029-43
references.pmid: 23201214
references.citation: BMJ. 2012 Mar 26;344:e1389
references.pmid: 22451477
references.citation: JAMA. 2002 Oct 23-30;288(16):1994-2000
references.pmid: 12387651
references.citation: Lancet. 2010 Nov 20;376(9754):1775-84
references.pmid: 21074255
references.citation: Circulation. 2011 Aug 16;124(7):789-95
references.pmid: 21810663
references.citation: Ann Behav Med. 2009 Oct;38(2):71-85
references.pmid: 20012809
references.citation: J Nutr. 1994 Nov;124(11 Suppl):2245S-2317S
references.pmid: 7965210
references.citation: Am J Epidemiol. 2000 Jul 15;152(2):99-106
references.pmid: 10909945
references.citation: Public Health Nutr. 2002 Feb;5(1A):157-62
references.pmid: 12027279
references.citation: Am J Prev Med. 2008 Jun;34(6):486-94
references.pmid: 18471584
references.citation: Sports Med. 2012 Apr 1;42(4):281-300
references.pmid: 22350570