title: Effectiveness of interventions to promote physical activity and/or decrease sedentary behaviour among rural adults: a systematic review and meta-analysis.
abstract: Physical inactivity and overweight and obesity are more prevalent among rural than urban populations. This study aimed to review published evidence of the effectiveness of interventions to increase physical activity (PA) and/or decrease sedentary behaviour (SB) among rural adults and to identify factors associated with effectiveness. Seven electronic databases were searched for controlled trials of a PA or SB intervention. Meta-analysis was conducted using random effects models and meta-regression. Thirteen studies were included in the qualitative synthesis (n = 4,848 participants) and 12 in the meta-analysis (n = 4,820). All studies were interventions to increase PA. Overall, there was no effect on PA (standardized mean difference [SMD] 0.11; 95% confidence interval [CI] -0.04, 0.25) or SB (SMD 0.07; 95% CI -0.33, 0.20). In PA subgroup analyses, studies employing objective outcome measures demonstrated effects in favour of the intervention (SMD 0.65, 95% CI 0.30, 1.00), while those using self-reported measures did not (SMD 0.00; 95% CI -0.11, 0.10). This review highlights significant gaps in our understanding of how best to promote PA and reduce SB among rural adults. Future studies should use objective measures of PA as study outcomes. The absence of interventions to decrease SB is of concern, with immediate action required to address this large knowledge gap.
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
authors.forename: V
authors.initials: V
authors.lastname: Cleland
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Squibb
authors.affiliation: Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Stephens
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Dalby
authors.affiliation: Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Timperio
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.|Faculty of Health, University of Tasmania, Hobart, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Winzenberg
authors.affiliation: Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Ball
authors.affiliation: School of Health Sciences, University of South Australia, Adelaide, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Dollman
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D018849:Controlled Clinical Trials as Topic; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control; D050177:Overweight / Q000517:prevention & control*; D012424:Rural Population; D057185:Sedentary Behavior
keywords: Adult; controlled trials; health behaviour; regional