Systematic Review of Interventions to Increase Physical Activity and Physical Fitness in African-Americans

Abstract

Objective.To identify characteristics of effective interventions designed to increase physical activity (PA) or fitness among African-Americans.Data Sources.Articles published between 1985 and 2006.Study Inclusion Criteria.Studies reporting PA or fitness change data in African-American participants were included.Data Extraction.Information on study design, intervention, data collection methods, and outcomes was extracted using a standardized form.Data Synthesis.Studies were ranked on quality and were summarized separately for adults and children.Results.We identified 29 studies in adults and 14 studies in children. Most were randomized controlled trials. All but six specifically targeted African-Americans; comparisons of effectiveness in African-Americans vs. others were not possible. Methodological heterogeneity limited comparisons of findings across studies. In adults, most studies showed significant within-group pre-post improvements in PA, but only 10 studies found differences between intervention and comparison groups. Most studies in children were null.Conclusions.Effective programs in adults were from randomized controlled trials and involved structured exercise programs. Studies with explicit cultural adaptations did not necessarily result in better PA outcomes. Additional studies are needed with larger sample sizes, longer follow-up, attention controls, strategies informed by proven behavior change theories, and objective PA assessment.