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Effectiveness of exercise-referral schemes to promote physical activity in adults: systematic review.

TLDR
In this article, the authors conducted a systematic review on the effectiveness of exercise-referral schemes in improving exercise participation in sedentary adults, and found that there was a statistically significant increase in the number of participants doing moderate exercise with a combined relative risk of 1.20 (95% confidence intervals = 1.06 to 1.35).
Abstract
Background Despite the health benefits of physical activity, most adults do not take the recommended amount of exercise. Aim To assess whether exercise-referral schemes are effective in improving exercise participation in sedentary adults. Design of study Systematic review. Method Studies were identified by searching MEDLINE, CINAHL, EMBASE, AMED, PsycINFO, SPORTDiscus, The Cochrane Library and SIGLE until March 2007. Randomised controlled trials (RCTs), observational studies, process evaluations and qualitative studies of exercise-referral schemes, defined as referral by a primary care clinician to a programme that encouraged physical activity or exercise were included. RCT results were combined in a meta-analysis where there was sufficient homogeneity. Results Eighteen studies were included in the review. These comprised six RCTs, one non-randomised controlled study, four observational studies, six process evaluations and one qualitative study. In addition, two of the RCTs and two of the process evaluations incorporated a qualitative component. Results from five RCTs were combined in a meta-analysis. There was a statistically significant increase in the numbers of participants doing moderate exercise with a combined relative risk of 1.20 (95% confidence intervals = 1.06 to 1.35). This means that 17 sedentary adults would need to be referred for one to become moderately active. This small effect may be at least partly due to poor rates of uptake and adherence to the exercise schemes. Conclusion Exercise-referral schemes have a small effect on increasing physical activity in sedentary people. The key challenge, if future exercise-referral schemes are to be commissioned by the NHS, is to increase uptake and improve adherence by addressing the barriers described in these studies.

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Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions

TL;DR: This comprehensive review of reviews identifies specific components which are associated with increased effectiveness in interventions to promote change in diet and/or physical activity to maximise the efficiency of programmes for diabetes prevention.
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Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials

TL;DR: Promotion of physical activity to sedentary adults recruited in primary care significantly increases physical activity levels at 12 months, as measured by self report, and there is insufficient evidence to recommend exercise referral schemes over advice or counselling interventions.
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Vitamin G: effects of green space on health, well-being, and social safety

TL;DR: The design of a research program on the effects of green space in the living environment on health, well-being and social safety is discussed, focusing on different target groups, using appropriate multilevel methods.
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Interventions to increase physical activity among healthy adults: meta-analysis of outcomes.

TL;DR: Interventions to increase activity should emphasize behavioral strategies over cognitive strategies, which is consistent with a mean difference of 496 ambulatory steps per day between treatment and control participants.
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Is exercise effective in promoting mental well-being in older age? A systematic review

TL;DR: Mental well-being in later life is modifiable through exercise and physical activity, and economic evidence indicated incremental cost-effectiveness ratios of £7300 and £12,100 per quality adjusted life year gained for community-based walking and exercise programmes, respectively.
References
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The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions.

TL;DR: It is shown that it is feasible to develop a checklist that can be used to assess the methodological quality not only of randomised controlled trials but also non-randomised studies and it is possible to produce a Checklist that provides a profile of the paper, alerting reviewers to its particular methodological strengths and weaknesses.
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Evaluating non-randomised intervention studies.

TL;DR: The inability of case-mix adjustment methods to compensate for selection bias and the inability to identify non- randomised studies that are free of selection bias indicate that non-randomised studies should only be undertaken when RCTs are infeasible or unethical.
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A Modification to the Behavioural Regulation in Exercise Questionnaire to Include an Assessment of Amotivation

TL;DR: The Behavioural Regulation in Exercise Questionnaire (BREQ) as discussed by the authors assesses external, identified, introjected, and intrinsic regulations, and assesses amotivation for exercise.
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Rationale and Standards for the Systematic Review of Qualitative Literature in Health Services Research

TL;DR: It is argued that three interrelated criteria can be identified as the foundation of good qualitative health research: interpretation of subjective meaning, description of social context, and attention to lay knowledge.
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The transtheoretical model of behavior change: a meta-analysis of applications to physical activity and exercise.

TL;DR: Results support the application of the transtheoretical model (TTM) in the physical activity domain by using the quantitative method of meta-analysis and there are sufficient data to confirm that stage membership is associated with different levels of physical activity, self-efficacy, pros and cons, and processes of change.
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