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

Abstract

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.