The "Romsås in Motion" community intervention: mediating effects of psychosocial factors on forward transition in the stages of change in physical activity.

This study examines whether a community-based physical activity intervention influenced movement in stages of change in physical activity in an adult population, whether any such effect was mediated by psychosocial influences, and whether any such mediations were moderated by sociodemographic or anthropometric factors. The 3-year-long pseudoexperimental intervention included physical activity, communication, environmental, and participatory components. Questionnaires assessed stages of change in physical activity and potential psychosocial mediators. Regression analyses revealed a significant favorable intervention effect on stages of change, partially mediated by enhanced support from family, perceived control, and physical activity identity. No moderation effects by gender, age, ethnicity, education, or body mass index were observed. Support from family, perceived control, and identity might be important intervention target points for inducing forward movement in the stages of change in physical activity, regardless of sociodemographic and anthropometric background factors.

The "Romsås in Motion" community intervention: program exposure and psychosocial mediated relationships to change in stages of change in physical activity.

BACKGROUND: Conducting process evaluations of health promoting interventions, and measuring the effectiveness of specific intervention components, may help in the understanding of program failure or success. The purposes of the present study were to examine adults' exposure to and involvement in specific components of a three year long pseudo-experimental community-based physical activity intervention, and to examine the relationship between such exposure and participation and changes in stages of change in physical activity and psychosocial mediators. METHODS: 1497 persons in the intervention group attended the baseline survey in 2000 (50.6%) and 1204 (80.4 of baseline attendees) provided data on the outcome variables of the present study. In 2003, 1089 were still living in the area, and were re-invited to follow-up assessments. Current analyses are based on the 603 persons (mean age 49 +/- 10 years) who provided baseline and follow-up data for the current purposes (56.6% follow-up rate). Process data, stages of change in physical activity, and potential psychosocial mediators of change in physical activity were assessed by questionnaires. The theory-based intervention was composed of communication, physical activity, environmental and participatory components. Data were analysed using frequency and descriptive statistics, Chi-square and t-tests, and regression analyses. RESULTS: Exposure and participation rates in the various intervention components varied greatly (1.5-92.7%). Participation in walking groups and aerobic exercise groups, as well as having seen the "Walk the stairs"-poster were significantly and positively related to change in stages of change in physical activity (beta = .12, p = .011; beta = .211, p < .001; beta = .105, p = .014, respectively). Additionally, having used the walk path was significantly and positively related to change in stages in women (beta = .209, p = .001) but not in men (beta = -.011, p = .879), and in Western people (beta = .149, p = .003) but not in non-Westerners (beta = -.293, p = .092). Observed significant relations were partly mediated by positive changes in psychosocial factors as social support from friends, perceived control, and physical activity identity. CONCLUSION: Findings revealed that particular intervention components, such as participation in physical activity groups, were more strongly related to forward transition in stages of change in physical activity than others. These findings together with results indicating that such transitions were mediated by specific psychosocial influences may improve theory and help to prioritize among specific intervention components in future programs.

Promoting physical activity in a low-income multiethnic district: effects of a community intervention study to reduce risk factors for type 2 diabetes and cardiovascular disease: a community intervention reducing inactivity.

OBJECTIVE: The aim was to assess the net effects on risk factors for type 2 diabetes and cardiovascular disease of a community-based 3-year intervention to increase physical activity. RESEARCH DESIGN AND METHODS: A pseudo-experimental cohort design was used to compare changes in risk factors from an intervention and a control district with similar socioeconomic status in Oslo, Norway, using a baseline investigation of 2,950 30- to 67-year-old participants and a follow-up investigation of 1,776 (67% of those eligible, 56% women, 18% non-Western immigrants) participants. A set of theory-based activities to promote physical activity were implemented and tailored toward groups with different psychosocial readiness for change. All results reported are net changes (the difference between changes in the intervention and control districts). At both surveys, the nonfasting serum levels of lipids and glucose were adjusted for time since last meal. RESULTS: The increase in physical activity measured by two self-reported questionnaires was 9.5% (P = 0.008) and 8.1% (P = 0.02), respectively. The proportion who increased their body mass was 14.2% lower in the intervention district (P < 0.001), implying a 50% relative reduction compared with the control district, and was lower across subgroups. Beneficial effects were seen for triglyceride levels (0.16 mmol/l [95% CI 0.06-0.25], P = 0.002), cholesterol-to-HDL cholesterol ratio (0.12 [0.03-0.20], P = 0.007), systolic blood pressure (3.6 mmHg [2.2-4.8], P < 0.001), and for men also in glucose levels (0.35 mmol/l [0.03-0.67], P = 0.03). The net proportion who were quitting smoking was 2.9% (0.1-5.7, P = 0.043). CONCLUSIONS: Through a theory-driven, low-cost, population-based intervention program, we observed an increase in physical activity levels, reduced weight gain, and beneficial changes in other risk factors for type 2 diabetes and cardiovascular disease.

Promoting physical activity in a multi-ethnic district - methods and baseline results of a pseudo-experimental intervention study.

BACKGROUND AND DESIGN: A combined community and high-risk intervention study of three years duration started in one district in Oslo after a baseline health survey in two multi-ethnic and low socio-economic status (SES) districts, using a pseudo-experimental design with an age-matched sample from the other district as controls. The intervention focused on promoting physical activity to reduce the burden of type 2 diabetes and cardiovascular disease (CVD). METHODS: A total of 6140 subjects were invited to participate (age group: 31-67). Data on health status and health-related behaviours, collected via standardized questionnaires, physical examinations and blood sample analyses, were available for 2950 persons (attendance rate 48%), whereas official statistics were available for the invited population. RESULTS: The prevalence of self-reported diabetes was 5.1% in men and 3.5% in women, but the total diabetes prevalence was 9% for men and 5.1% for women. One-third of the population were sedentary in their leisure time, men more than women (38% versus 29%). The prevalence of obesity did not differ between the genders (21% had BMI 30 kg/m(2)). The relatively high mean scores on most psychosocial variables related to physical activity, especially among women, indicate a high motivational readiness for increase in physical activity behaviour. The baseline data, for example on the prevalence of chronic diseases were similar in the two districts. CONCLUSION: The prevalence of self-reported diabetes is remarkably higher than reported from other studies in Norway. The proportion of undiagnosed diabetes was higher than anticipated, and constituted 39% of all those categorized as diabetics.