title: Interventions aimed at increasing the level of physical activity by including organised follow-up: a systematic review of effect.
abstract: BACKGROUND
  Organised follow-up is a common feature of several strategies at the primary health care level to promote health behaviour change, e.g. to increase physical activity. In Norway, municipal 'healthy living' centres run by health care personnel are established to offer counselling and organised follow-up of health behaviour change during a 12-week programme. We report the results of a systematic review commissioned by the Norwegian Directorate of Health concerning organised follow-up to improve physical activity.
  
  
  METHODS
  We searched ten electronic databases up to June 2012, reference lists of included publications, and relevant journals. Study selection and quality risk of bias assessment were carried out independently. Data were synthesised narratively due to heterogeneity of measurements of physical activity. The GRADE approach was used to assess our confidence in the effect estimate for each outcome in each comparison.
  
  
  RESULTS
  Fourteen randomised controlled trials from seven countries and with a total of 5,002 participants were included in the systematic review. All studies were carried out in primary care or community settings. The interventions comprised referral to supervised group physical activity (2 studies), referral to local resources with follow-up (6 studies), and self-organised physical activity with follow-up (6 studies). The narrative synthesis, comprising a total of 39 comparisons, indicated effects of self-organised physical activity with follow-up (compared to both advice and no treatment) and referral to local resources with follow-up (compared to advice) in some of the comparisons where we rated our confidence in the effect estimates as moderate. However, the results indicated no difference between intervention and control groups for the majority of comparisons. Follow-up in the studies was mainly short-term with the longest follow-up 9 months post-treatment. We rated our confidence in the effect estimates as low or very low in most comparisons, both for positive and neutral results.
  
  
  CONCLUSIONS
  The results of this systematic review indicate considerable uncertainty concerning effects of organised follow-up during 10-14 weeks on physical activity. Major methodological problems concerning the measurement of physical activity are discussed.
  
  
  BACKGROUND
  Systematic review registration: PROSPERO CRD42011001598.
authors.affiliation: Norwegian Knowledge Centre for the Health Services, Oslo, Norway. Eva.Denison@nokc.no.
authors.forename: Eva
authors.initials: E
authors.lastname: Denison
authors.forename: Gunn E
authors.initials: GE
authors.lastname: Vist
authors.forename: Vigdis
authors.initials: V
authors.lastname: Underland
authors.forename: Rigmor C
authors.initials: RC
authors.lastname: Berg
mesh_terms: D003151:Community Health Centers; D003376:Counseling / Q000379:methods* / Q000458:organization & administration; D015444:Exercise; D006801:Humans; D009043:Motor Activity; D009664:Norway; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration; D040242:Risk Reduction Behavior