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Physical activity is a key behavioral component for the primary prevention of noncommunicable disease. The uptake of physical activity is influenced by individual and broader factors including social, economic, and environmental conditions.
The purpose of this paper is to describe a protocol for a scoping review of reviews (SRR) that aims to map a decade of research focused on physical activity interventions within the domain of primary prevention.
The 5 stages of our SRRs design were adapted from a seminal scoping review methodology. Our search strategy was developed for the following databases: SPORTDiscus, PubMed, Scopus, the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and Educational Resources Information Centre. Two reviewers (LG and AK) independently screened eligible studies and compared results to determine the final study selection. One reviewer will conduct the data extraction (LG); a second reviewer (AK) will assess the results to ensure comprehensiveness and accuracy of the scoping review synthesis.
The SRRs will provide a broad overview of the physical activity research literature specific to primary prevention, and will describe key features of physical activity interventions. Potential gaps in the physical activity action areas will be identified, and thus, the results will inform future research directions.
This paper describes an innovative approach for comprehensively mapping an important topic’s research trends in the last decade.
Physical activity provides health benefits that include stress reduction, improved functional ability, and a key means of energy expenditure that contributes to weight control [
Broadly, physical activity is defined as any bodily movement produced by skeletal muscles, which requires energy expenditure [
Enhancing physical activity is a complex behavior change that is influenced by multiple factors [
The proliferation of physical activity literature over the last decade addresses many relevant aspects: different types and intensities of exercise, sport, and leisure-time physical activity and their effects on health; the influence of settings (barriers/facilitators) on physical activity behaviors; and policies developed in response to the alarming global trend of decreasing physical activity levels. Given the recognition of physical activity as important for preventing chronic disease, and the vast amount and complexity of published literature on this topic, a broad overview that maps physical activity research literature specific to primary prevention is warranted.
Reviews conducted in health disciplines tend to be systematic reviews of particular interventions or outcomes, but despite the rigorous results they produce to address specific questions, these methods are less useful when the aim is to address complex practice issues or broad research questions [
A scoping review is an ideal methodology for mapping key concepts within a research area and for identifying main sources and types of evidence available when the research literature is vast or diverse, or both [
Our SRR approach is adapted from Arksey and O’Malley’s scoping methodology that describes up to 6 stages of the scoping review process [
Similar to other review designs [
Which physical activity strategies are being addressed in the literature [
Individual-targeted interventions (eg, individual behavioral interventions)
Education or promotion (national, regional, or local informational education or promotion)
Supportive social environments (eg, counselors, mentors, role models)
Supportive physical environments (relevant settings and opportunities that determine availability)
Policy (government or organizational policy)
Multicomponent interventions (ie, several health-related strategies in a single intervention)
Which individuals or groups are targeted in the physical activity literature [
Individuals (eg, children, youth, adults)
Family
Community
Subpopulation (eg, age group)
Sectors (eg, schools, workplaces, primary care providers)
Society (ie, general population)
How is equity addressed in the physical activity review literature?
Equity is explicitly stated in the research objective
Includes equity categories based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Equity 2012 Extension [
What factors are being researched that may influence physical activity uptake?
Social and health determinants
Correlates
Mediators/Moderators
Barriers
What are the trends in physical activity concepts, action areas, and population targets?
Which reviews explicitly examine intervention effectiveness or efficacy?
Our SRR aimed to be comprehensive in identifying relevant studies, yet we limited our scope to include only published review literature to manage the vast quantity of physical activity literature. Team discussions established the eligibility criteria in the preliminary planning of the SRR analysis (
A comprehensive search was performed in the following electronic databases: SPORTDiscus, PubMed, Scopus, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and Educational Resources Information Centre. Boolean terms “AND” and “OR” were used to build the keyword searches in the databases. We developed our search around physical activity intervention concepts and keywords that are broad, yet relate specifically to physical activity interventions within the domain of primary prevention (
Inclusion criteria
Published in English
Human subjects
Date range January 2003 to June 2014
All age groups
Research that targets the general population where no illness/condition is identified.
Review methods specifically described a systematic review, meta-analysis, meta-synthesis, scoping review, rapid review, critical review, or described a systematic approach.
Research located in developed Westernized countries (Canada, United States, Europe, United Kingdom, Australia, and New Zealand).
Exclusion criteria
Journal articles that are not rigorous reviews (ie, those not listed in the inclusion list), such as book reviews, opinion articles, commentaries, or editorial reviews.
Research targeting a population because of a diagnosed illness or disease or interventions targeting treatment of a specific disease, illness, or condition.
Research about direct health benefits from physical activity.
Research that focuses on research design (eg, methods, protocols, theories).
We used a 2-stage study-selection process. In the first stage, a single reviewer applied the defined inclusion criteria (ie, interventions targeting healthy populations in developed countries) to titles and abstracts. Reviews that were overtly ineligible were removed, such as physical activity interventions that treated a previously existing health condition. All potentially eligible studies were then distributed to 2 independent reviewers (LG and AK) on the team. Each reviewer applied the eligibility criteria (
The data-extraction tool was developed using an iterative team process. The preliminary data-extraction categories were derived from our overarching research questions (
Our data-extraction categories (
Data-extraction tool.
Data | Details extracted |
Article summary | Author |
Title | |
Publication year | |
Number of studies | |
Date range | |
Review type | |
Population | Age (eg, adults) |
Descriptors (eg, workplace) | |
Action areas | Policy |
Education/Promotion | |
Supportive physical environments | |
Supportive social environments | |
Multicomponent interventions | |
Physical activity concept | For example, leisure-time physical activity |
Intervention | Descriptors |
Objectives | |
Measures | |
Review focus | Process |
Impact | |
Outcomes | |
Equity | Explicitly stated? Yes/No |
Equity-related categories | For example, ethnicity |
Effectiveness/efficacy | Factors that contribute to intervention effectiveness or efficacy |
This physical activity SRR will provide an overview of the breadth of physical activity research to inform our primary prevention research agenda. We will use Arksey and O’Malley’s methods of reporting and provide a descriptive analysis of the extent, nature, and distribution of the studies included in the review [
Our study is a scoping review of published reviews that is not limited to systematic reviews. We chose a broader selection of review literature to comprehensively explore physical activity interventions aimed at primary prevention. Extracting data from a variety of reviews may prove difficult, because the included studies will have a wide range of methodological approaches, settings, study populations, and behaviors. However, our goal is to map trends rather than answer a specific question, which will provide novel insights with regard to future research needs to enhance current primary prevention policies and programs.
A potential limitation of this study may be a lack of quality assessment of the included articles, yet this is typical of a scoping review [
Physical activity is an important intervention for the primary prevention of noncommunicable diseases and the promotion of health. Research suggests interventions require a multidimensional approach that encompasses the broader social, economic, and environmental factors that influence behavior [
Search strategy for SPORTDiscus.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
scoping review of reviews
World Health Organization
This work was supported by The Manitoba Research Chair in Primary Prevention awarded to Dr Alan Katz by the Manitoba Health Research Council and the Heart and Stroke Foundation of Manitoba.
AK conceptualized the review approach and provided general guidance to the research team. AK and LG drafted the manuscript, followed by numerous iterations and substantial input and appraisal from all other authors. All authors have approved the final version of this manuscript.
None declared.