LIFE-STYLE PHYSICAL-ACTIVITY INTERVENTIONS - HISTORY, SHORT-TERM AND LONG-TERM EFFECTS, AND RECOMMENDATIONS

Introduction: Lifestyle physical activity interventions have resulted in response to the public health problem of promoting regular amounts of physical activity to the majority of U.S. adults who remain inadequ ately or completely inactive. These lifestyle interventions allow a pe rson to individualize his/her physical activity programs to include a wide variety of activities that are at least of moderate intensity and to accumulate bouts of these activities in a manner befitting his/her life circumstances. Methods: We reviewed the history of lifestyle phy sical activity interventions and defined lifestyle physical activity b ased on this review. We located 14 studies that met this definition. R esults: Lifestyle physical activity interventions are effective at inc reasing and maintaining levels of physical activity that meet or excee d public health guidelines for physical activity in representative sam ples of previously sedentary adults and obese children. The majority o f these interventions have been delivered by face-to-face contact in s mall groups, which limits their public health impact. However, a small number of studies demonstrate that these interventions can be deliver ed by mail and telephone, which may enhance their generalizability. Mo st of these studies utilized behavior change theories such as Social C ognitive Theory, the Transtheoretical Model, and Behavior Learning to shape the interventions. Lifestyle interventions aimed at modifying th e environment, such as signs posted to increase stair climbing, also h ave been shown to be effective over the short term. Conclusion: The ma jor issues concerning lifestyle physical activity interventions are: ( I) testing their ability to be implemented on a large scale; (2) exami ning cost-effectiveness for different modes of delivery; and (3) resea rching the efficacy in populations such as the elderly, minorities, ec onomically disadvantaged, and individuals with concurrent disease. Mor e studies aimed at manipulating the environment to increase physical a ctivity need to be tested over periods of one year or longer. It is po ssible that lifestyle interventions could be integrated and delivered by new technologies such as interactive computer-mediated programs, te lephone, or computer web-based formats. All of these recommended appro aches should utilize valid and reliable measures of physical activity and should examine the health effects, particularly on a longitudinal basis. Basic dose-response studies in controlled settings also are nee ded to help us understand the health effects of accumulated moderate i ntensity activity.