ukactive update VANGUARD Real World Research
Steven Mann, lead researcher at the ukactive Research Institute, talks to HCM about its
research conducted in community fitness centres, and its implications for the delivery of physical activity interventions
Q: How can we put the principle of ‘exercise is medicine’ into practice? A: The evidence showing that a sedentary lifestyle is associated with chronic diseases such as heart disease is irrefutable. There’s also a huge body of evidence demonstrating the prevention and management of such conditions through physical activity. But the translation of this evidence into practice is one of the greatest challenges facing health promotion and disease prevention.
Q: What do you see as the biggest barrier? A: Controlled environments such as labs – in which most research into physical activity and health is conducted – is reducing the transferability of the fi ndings into community settings. It makes sense for research to be conducted in the same, or closely related, place of delivery in the real world. Participants also need to be representative of those most in need of the ‘treatment’ being proposed. In this instance, that setting is community fi tness centres and the treatment is exercise. If more research were conducted in real
world environments, the results would have more relevance to, and application in, public health. Our study found that, of 1,225 peer- reviewed articles found in searches, only 22 were relevant, and just 11 articles described an intervention delivered in a community fi tness centre and reported its impact.
Q: What do you think would help studies be more successful? A: Physical activity interventions are generally reported as successful, with several common themes emerging, one of which is that supervised physical activity is associated with better outcomes. A key issue of studies is retention – many programmes are front-loaded in terms of
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Studies should be conducted in communities, involving those most in need of intervention
supervision, putting more of an emphasis on the beginning of the programme. We found that spreading supervision throughout the programme, with post-programme follow-up, may increase retention and help maintain physical activity levels.
Q: You found that common methods of measuring outcomes may actually limit studies. Can you elaborate? A: There are limitations that infl uence what we can count as reliable or certain. Take self-reporting as an example. It might be biased as participants may, wittingly or unwittingly, change what they say based on what they think researchers want to hear. One study from 2012 showed
that, while 39 per cent of males and 29 per cent of females self-reported achieving recommended levels of activity, accelerometer data showed only 6 per cent and 4 per cent respectively actually did so. Another common criticism of research is that volunteers for physical activity interventions are often already motivated to change, arguably positively aiding the success of interventions. This limits the ability to generalise fi ndings to less motivated members.
Body mass index (BMI) measure is used
widely in studies, but it’s a crude measure that may mask clinically signifi cant changes in lean or fat mass. An analysis of body composition provides more clinically relevant information.
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Q: So what needs to be done? A: The measurement and evaluation of real world initiatives must be clinically relevant, rigorous and stand up to academic scrutiny. As so few physical activity studies have
taken place in community environments like leisure centres, the commissioning and administration of such interventions might be hampered. With public health budgets now in the hands of local authorities, we need to be sending an evidence-based message: ‘physical activity interventions work, and this is how you can deliver them successfully’. We can’t expect community- based programmes to achieve the same results as those delivered in the lab. These principles provide the basis of all the research the Institute carries out.
NEED ADVICE OR MORE INFO?
The ukactive Research Institute fi ndings will be published in the ‘Exercise is Medicine’ special being featured in the July/August edition of Current Sports Medicine Reports. For guidance on how to implement a study within your facility, or for advice on what to do with data you may already have collected, please contact Stephen Wilson, policy and public affairs director, on +44 (0)20 7593 8572 or
stephenwilson@ukactive.org.uk
June 2014 © Cybertrek 2014
PHOTO:
SHUTTERSTOCK.COM / ANDREW BASSETT
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