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{"sheet":"Built Environ","index":0,"n_rows":99,"n_cols":5,"rows_kept":99,"cut":false,"hidden":false,"merged":[[20,1,20,4],[22,1,47,1],[22,2,47,2],[22,3,47,4],[97,1,97,4],[48,1,58,1],[48,2,58,2],[48,3,58,4],[59,1,82,1],[59,2,82,2],[59,3,82,4],[83,1,95,1],[83,3,95,4],[83,2,95,2],[99,1,140,1],[99,2,140,2],[99,3,140,3],[99,4,140,4]]}
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[null,"GUIDANCE - BUILT ENVIRONMENT"]
[null,"Source:","Audience:","Recommendations:"]
[null,"National Institute for Health and Care Excellence. Physical activity for children and young people. PH17. London: NICE; 2009 (updated 2020). \nAvailable here.\n","•Children’s trusts and services, early years providers, schools and college\n•Community and voluntary groups (running sports and other organised activities)\n•Government departments\n•Local authorities (leisure and related services, transport and planning, regeneration) and local strategic partnerships\n•Organisations offering practitioners education and training\n•The police\n•Primary care trusts\n•Private sector providers\n•Children, young people, their families and carers and members of the public","This guideline covers promoting physical activity for children and young people aged under 18 at home, preschool, school and in the community. It includes raising awareness of the benefits of physical activity, listening to what children and young people want, planning and providing spaces and facilities, and helping families build physical activity into their daily lives.\n\nThis guideline includes recommendations on:\n•delivering a national campaign and raising awareness about physical activity\n•developing physical activity plans\n•planning the provision of spaces and facilities\n•responding to what children and young people want\n•multi-component school and community programmes\n•active and sustainable school travel plans\n•helping children and families to be active\n"]
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[null,"National Institute for Health and Care Excellence. Physical activity: encouraging activity in the community. QS183. London: NICE; 2019. \nAvailable here.\n","Local authorities and healthcare commissioning groups\nWorkplaces\nSchools and early years settings\n","This quality standard covers how local strategy, policy and planning and improvements to the built or natural physical environment such as public open spaces, workplaces and schools can encourage and support people of all ages and all abilities to be physically active and move more. It describes high-quality care in priority areas for improvement.\n\n\nThis quality standard is expected to contribute to improvements in the following outcomes:\n\n•physical activity in adults, young people and children\n•outdoor space usage for exercise or health reasons\n•active travel\n"]
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[null,"National Institute for Health and Care Excellence. Physical activity and the environment. NG90. London: NICE; 2018. \nAvailable here.\n\n\nUnderpinning evidence reviews for March 2018 are available here.\n\n\nUnderpinning evidence reviews for January 2008 are available here.","•Local authorities and metro mayors, including agencies contracted to deliver environmental changes for local authorities\n•Others responsible for open spaces used by the public such as in workplaces, community-owned gardens and playing fields\n•Housing, local enterprise partnerships and others responsible for the built environment\n•Public transport planners and providers\n•Organisations working to ensure people with limited mobility can be physically active\n\nIt may also be relevant for members of the public.\n","This guideline covers how to improve the physical environment to encourage and support physical activity. The aim is to increase the general population’s physical activity levels.\n\nThis guideline includes recommendations on:\n•strategies, policies and plans to increase physical activity in the local environment\n•active travel\n•public open spaces\n•buildings\n•schools\n"]
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[null,"National Institute for Health and Care Excellence. Physical activity: for NHS staff, patients and carers. QS84. London: NICE; 2015. \nAvailable here.\n","NHS staff, patients and carers. ","This quality standard covers encouraging physical activity in people of all ages who are in contact with the NHS, including staff, patients and carers. It describes high-quality care in priority areas for improvement.\n\nThe quality standard is expected to contribute to improvements in the following outcomes:\n\n\n•cardiovascular health\n•excess weight in adults\n•excess weight in children and young people under 18 years\n•physically active adults\n•physically active children\n•self-reported wellbeing \n•use of outdoor space for exercise and health reasons.\n"]
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[null,"SYSTEMATIC REVIEWS - BUILT ENVIRONMENT"]
[null,"Source:","Population:","Findings:","Authors' Conclusions:"]

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{"sheet":"FULL MAP","index":3,"n_rows":557,"n_cols":5,"rows_kept":557,"cut":false,"hidden":false,"merged":[[23,1,23,4],[25,1,49,1],[25,2,49,2],[25,3,49,4],[50,2,74,2],[50,1,74,1],[50,3,74,4],[229,2,262,2],[263,2,280,2],[263,3,280,3],[263,4,280,4],[188,1,188,4],[93,1,115,1],[93,2,115,2],[93,3,115,4],[75,1,92,1],[75,2,92,2],[75,3,92,4],[130,1,144,1],[130,2,144,2],[159,1,169,1],[159,2,169,2],[159,3,169,4],[170,1,179,1],[170,2,179,2],[170,3,179,4],[130,3,144,4],[116,1,129,1],[116,2,129,2],[116,3,129,4],[145,2,158,2],[145,1,158,1],[145,3,158,4],[281,1,299,1],[281,2,299,2],[281,3,299,3],[281,4,299,4],[300,1,324,1],[300,2,324,2],[300,3,324,3],[300,4,324,4],[180,1,185,1],[180,2,185,2],[180,3,185,4],[186,3,186,4],[229,1,262,1],[229,3,262,3],[229,4,262,4],[263,1,280,1],[213,1,228,1],[213,2,228,2],[213,4,228,4],[213,3,228,3],[190,1,212,1],[190,2,212,2],[190,3,212,3],[190,4,212,4],[358,2,376,2],[358,1,376,1],[358,3,376,3],[358,4,376,4],[377,1,409,1],[377,2,409,2],[377,3,409,3],[377,4,409,4],[325,2,340,2],[325,1,340,1],[325,3,340,3],[325,4,340,4],[341,2,357,2],[341,3,357,3],[341,4,357,4],[341,1,357,1],[452,3,473,3],[452,2,473,2],[452,1,473,1],[452,4,473,4],[474,1,487,1],[474,2,487,2],[474,3,487,3],[474,4,487,4],[410,1,436,1],[410,2,436,2],[410,3,436,3],[410,4,436,4],[437,1,451,1],[437,2,451,2],[437,3,451,3],[437,4,451,4],[538,1,555,1],[538,2,555,2],[538,3,555,3],[538,4,555,4],[556,1,576,1],[556,2,576,2],[556,3,576,3],[556,4,576,4],[488,4,506,4],[507,1,518,1],[507,2,518,2],[507,3,518,3],[507,4,518,4],[519,1,537,1],[519,2,537,2],[519,3,537,3],[519,4,537,4],[488,1,506,1],[488,2,506,2],[488,3,506,3]]}
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[null,"GUIDANCE SECTION - FULL MAP"]
[null,"Source:","Audience:","Recommendations:"]
[null,"National Institute for Health and Care Excellence. Physical activity for children and young people. PH17. London: NICE; 2009 (updated 2020). \nAvailable here.\n\n\n\n\n","•Children’s trusts and services, early years providers, schools and college\n•Community and voluntary groups (running sports and other organised activities)\n•Government departments\n•Local authorities (leisure and related services, transport and planning, regeneration) and local strategic partnerships\n•Organisations offering practitioners education and training\n•The police\n•Primary care trusts\n•Private sector providers\n•Children, young people, their families and carers and members of the public\n","This guideline covers promoting physical activity for children and young people aged under 18 at home, preschool, school and in the community. It includes raising awareness of the benefits of physical activity, listening to what children and young people want, planning and providing spaces and facilities, and helping families build physical activity into their daily lives.\n\nThis guideline includes recommendations on:\n•Delivering a national campaign and raising awareness about physical activity\n•Developing physical activity plans\n•Planning the provision of spaces and facilities\n•Responding to what children and young people want\n•Multi-component school and community programmes\n•Active and sustainable school travel plans\n•Helping children and families to be active"]
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[null,"National Institute for Health and Care Excellence. Behaviour change: digital and mobile health interventions. NG183. London: NICE; 2020.\nAvailable here.\n","•Local policy makers and commissioners\n•Individuals, groups or organisations wishing to work or working with health and social care service providers\n•Designers and providers of digital and mobile health interventions and programmes\n•Behaviour change practitioners\n•Trained staff working in health and social care services who have contact with the general public\n•People who want to improve their health-related behaviours (concerning diet and physical activity, smoking, alcohol use and safer sex), their families or carers, and other members of the public","This guideline covers interventions that use a digital or mobile platform to help people eat more healthily, become more active, stop smoking, reduce their alcohol intake or practise safer sex. The interventions include those delivered by text message, apps, wearable devices or the internet. The guideline only includes those that are delivered by the technology itself and not by healthcare professionals using technology to deliver interventions.\n\nThis guideline includes recommendations on:\n•Developing digital and mobile health interventions\n•Commissioning digital and mobile health interventions\n•Using digital and mobile health interventions\n•Interventions for diet and physical activity\n"]
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[null,"National Institute for Health and Care Excellence. Mental wellbeing in over 65s: occupational therapy and physical activity interventions. PH16. London: NICE; 2008.\nAvailable here.\n\n\nNOTE: Recommendation 2 was updated 2020 and has been included; other recommendations and the guidance as a whole are older than 10 years. \n","Older people and their carers","This guideline covers promoting mental wellbeing in people aged over 65. It focuses on practical support for everyday activities, based on occupational therapy principles and methods. This includes working with older people and their carers to agree what kind of support they need.\n\nRecommendation 2 is aimed at:\n-Physiotherapists, registered exercise professionals and fitness instructors and other health, social care, leisure services and voluntary sector staff who have the qualifications, skills and experience to deliver exercise programmes appropriate for older people.\n\nRecommendation 2 suggests:\n-In collaboration with older people and their carers, offer tailored exercise and physical activity programmes in the community"]
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[null,"National Institute for Health and Care Excellence. Physical activity and the environment. NG90. London: NICE; 2018. \nAvailable here.\n\nUnderpinning evidence reviews:\n\nEvidence Review 1 here.\n\nEvidence Review 2 here.\n\nEvidence Review 3 here.\n\n\n\n\n\n","•Local authorities and metro mayors, including agencies contracted to deliver environmental changes for local authorities\n•Others responsible for open spaces used by the public such as in workplaces, community-owned gardens and playing fields\n•Housing, local enterprise partnerships and others responsible for the built environment\n•Public transport planners and providers\n•Organisations working to ensure people with limited mobility can be physically active\n\nIt may also be relevant for members of the public","This guideline covers how to improve the physical environment to encourage and support physical activity. The aim is to increase the general population’s physical activity levels.\n\nThis guideline includes recommendations on:\n•Strategies, policies and plans to increase physical activity in the local environment\n•Active travel\n•Public open spaces\n•Buildings\n•Schools\n"]
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[null,"National Institute for Health and Care Excellence. Community pharmacies: promoting health and wellbeing. NG102. London: NICE; 2018. \nAvailable here.\n","•Community pharmacies, local pharmaceutical committees and pharmacy organisations\n•Commissioners of health-promoting interventions including local authorities, clinical commissioning groups and NHS England\n•Local professional networks (hosted by NHS England)\n•Health and wellbeing boards\n","This guideline covers how community pharmacies can help maintain and improve people’s physical and mental health and wellbeing, including people with a long-term condition. It aims to encourage more people to use community pharmacies by integrating them within existing health and care pathways and ensuring they offer standard services and a consistent approach. It requires a collaborative approach from individual pharmacies and their representatives, local authorities and other commissioners\n\nThis guideline includes recommendations on:\n•Health and wellbeing hub\n•Overarching principles of good practice\n•Awareness raising and providing information\n•Advice and education\n•Behavioural support\n•Referrals and signposting"]
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[null,"National Institute for Health and Care Excellence. Behaviour change: general approaches. PH6. London: NICE; 2017. \nAvailable here.\n\nUnderpinning evidence review here.\n\n\n","•National policy makers, commissioners, providers and practitioners in the NHS, local authorities and the community and voluntary sectors\n•Researchers, including those who oversee research funding\n•Social and behavioural scientists\n•Health economists working on health-related knowledge, attitude and behaviour change","This guideline covers a set of principles that can be used to help people change their behaviour. The aim is for practitioners to use these principles to encourage people to adopt a healthier lifestyle by, for example, stopping smoking, adopting a healthy diet and being more physically active.\n\nThis guideline recommends a set of principles to use as the basis for:\n•Providing education and training for those delivering them\n•Delivery of these activities, including one-to-one and community-based programmes and those aimed at specific populations\n•Evaluation of their effectiveness and cost effectiveness\n"]
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[null,"National Institute for Health and Care Excellence. Physical activity: exercise referral schemes. PH54. London: NICE; 2014. \nAvailable here.\n\nUnderpinning evidence review here.\n\n\n","•Policy makers and commissioners in local authorities and the NHS\n•Primary care practitioners and other practitioners with physical activity as part of their remit\n•Providers of exercise referral schemes\n•Organisations that provide exercise qualifications and accreditation\n•Members of the public","This guideline covers exercise referral schemes for people aged 19 and older, in particular, those who are inactive or sedentary. The aim is to encourage people to be physically active.\n\nThis guideline includes recommendations on:\n•Exercise referral for people who are sedentary or inactive but otherwise healthy\n•Exercise referral for people who are sedentary or inactive and have a health condition or other health risk factors"]
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[null,"National Institute for Health and Care Excellence. Behaviour change: individual approaches. PH49. London: NICE; 2014. \nAvailable here.\n","•Healthcare professionals\n•Commissioners and providers\n•Young people and adults, and their families and carers","This guideline covers changing health-damaging behaviours among people aged 16 and over using interventions such as goals and planning, feedback and monitoring, and social support. It aims to help tackle a range of behaviours including alcohol misuse, poor eating patterns, lack of physical activity, unsafe sexual behaviour and smoking.\n\nThis guideline includes recommendations on:\n•Developing local behaviour change policy and strategy\n•Commissioning interventions\n•Planning interventions that take account of local needs\n•Ensuring interventions meet individual needs\n•Delivering interventions\n•Commissioning and providing training\n•Monitoring and evaluating interventions"]
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[null,"National Institute for Health and Care Excellence. Physical activity: brief advice for adults in primary care. PH44. London: NICE; 2013.\nAvailable here.\n\nUnderpinning evidence review here.\n\n\n","•Commissioners and practitioners\n•Members of the public","This guideline covers providing brief advice on physical activity to adults in primary care. It aims to improve health and wellbeing by raising awareness of the importance of physical activity and encouraging people to increase or maintain their activity level.\n\nThis guideline includes recommendations on:\n•Identifying adults who are inactive\n•Delivering and following up on brief advice\n•Incorporating brief advice in commissioning\n•Systems to support brief advice\n•Providing information and training\n"]
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[null,"National Institute for Health and Care Excellence. Physical activity: walking and cycling. PH41. London: NICE; 2012. \nAvailable here.\n","•Commissioners, managers and practitioners\n•Members of the public","This guideline covers encouraging people to increase the amount they walk or cycle for travel or recreation purposes.\n\nThis guideline includes recommendations on:\n•Policy and planning\n•Local programmes\n•Schools, workplaces and the NHS\n"]
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[null,"SYSTEMATIC REVIEW SECTION - FULL MAP"]
[null,"Source:","Population:","Findings:","Authors' Conclusions:"]
[null,"Virgara  R, et al. Interventions in outside‐school hours childcare settings for promoting physical activity amongst schoolchildren aged 4 to 12 years. Cochrane Database of Systematic Reviews 2021, Issue 9. Art. No.: CD013380. DOI: 10.1002/14651858.CD013380.pub2.\nAvailable here\n","Children aged 4 to 12 years in outside‐school hours childcare settings.","This review sought to assess the effectiveness, cost-effectiveness and associated adverse events of interventions designed to increase physical activity in children aged 4 to 12 years in outside-school hours childcare settings.\nThere was low-certainty evidence that physical activity interventions may have little to no effect on total daily moderate-to-vigorous physical activity compared to no intervention (MD 1.7 minutes, 95% CI –0.42 to 3.82; P = 0.12; 6 trials; 3042 children). The authors were unable to pool data on proportion of the OSHC session spent in moderate-to-vigorous physical activity in a meta-analysis. Both trials showed an increase in proportion of session spent in moderate-to-vigorous physical activity (moderate-certainty evidence) from 4% to 7.3% of session time; however, only one trial was statistically significant. \nThere was low-certainty evidence that physical activity interventions may lead to little to no reduction in body mass index (BMI) as a measure of cardiovascular health, compared to no intervention (SMD –0.17, 95%CI –0.44 to 0.10; P = 0.22; 4 trials, 1684 children). \nPhysical activity interventions that were delivered online were more cost-effective than in person. Combined results suggest that staff-and-parent and staff-and-child-based interventions may lead to a small increase in overall daily physical activity and a small reduction or no difference in BMI. \nProcess evaluation was assessed differently by four of the included studies, with two studies reporting improvements in physical activity practices, one reporting high programme satisfaction and one high programme fidelity. The certainty of the evidence for these outcomes was low to moderate. Finally, there was very low-certainty evidence that physical activity interventions in outside-school hours childcare settings may increase cardiovascular fitness.\n","Although the review included nine trials, the evidence for how to increase children's physical activity in outside-school hours care settings remains limited, both in terms of certainty of evidence and magnitude of the effect. \nOf the types of interventions identified, when assessed using GRADE there was low-certainty evidence that multi-component interventions, with a specific physical activity goal may have as mall increase in daily moderate-to-vigorous physical activity and a slight reduction in BMI. \nThere was very low-certainty evidence that interventions increase cardiovascular fitness. By contrast there was moderate-certainty evidence that interventions were effective for increasing proportion of time spent in moderate-to-vigorous physical activity, and online training is cost-effective.\n\n"]
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[null,"Neil-Sztramko  SE, Caldwell  H, Dobbins  M. School‐based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database of Systematic Reviews 2021, Issue 9. Art. No.: CD007651. DOI: 10.1002/14651858.CD007651.pub3.\nAvailable here\n","School-attending children and adolescents between the ages of 6 and 18 years.","Results show that school‐based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate‐certainty evidence) and may lead to little to no decrease in sedentary time (MD ‐3.78 minutes/d, 95% CI ‐7.80 to 0.24; 16 studies; low‐certainty evidence). \nSchool‐based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low‐certainty evidence). School‐based physical activity interventions may result in a very small decrease in BMI z‐scores (MD ‐0.06, 95% CI ‐0.09 to ‐0.02; 21 studies; low‐certainty evidence) and may not impact BMI expressed as kg/m² (MD ‐0.07, 95% CI ‐0.15 to 0.01; 50 studies; low‐certainty evidence).\n","Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school‐based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously."]
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[null,"Freak-Poli  RLA et al. Workplace pedometer interventions for increasing physical activity. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No.: CD009209. DOI: 10.1002/14651858.CD009209.pub3.\nAvailable here.\n","Both healthy populations and those at risk of chronic disease (e.g. through inactivity or overweight), with a mean age of 41 years","This Cochrane review sought to assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving long-term health outcomes.\n\nWhen pedometer interventions are compared to minimal interventions at follow-up points at least one month after completion of their intervention, pedometers may have no effect on physical activity (6 studies; very low-certainty evidence; no meta-analysis due to very high heterogeneity), but the effect is very uncertain. \n\nPedometers may have effects on sedentary behaviour and on quality of life (mental health component), but these effects were very uncertain (1 study; very low-certainty evidence).\n\nPedometer interventions may slightly reduce anthropometry (body mass index (BMI) -0.64, 95% confidence interval (CI) -1.45 to 0.18; 3studies; low-certainty evidence). \n\nPedometer interventions probably had little to no effect on blood pressure (systolic: -0.08 mmHg, 95% CI -3.26 to 3.11; 2 studies; moderate-certainty evidence) and may have reduced adverse effects (such as injuries; from 24 to 10 per 100 people in populations experiencing relatively frequent events; odds ratio (OR) 0.50, 95% CI 0.30 to 0.84; low-certainty evidence). \n\nNo studies compared biochemical measures or disease risk scores at follow-up after completion of the intervention versus a minimal intervention. \n\nComparison of pedometer interventions to alternative physical activity interventions at follow-up points at least one month after completion of the intervention revealed that pedometers may have an effect on physical activity, but the effect is very uncertain (1 study; very low-certainty evidence). \n\nSedentary behaviour, anthropometry (BMI or waist circumference), blood pressure (systolic or diastolic),biochemistry (low-density lipoprotein (LDL) cholesterol, total cholesterol, or triglycerides), disease risk scores, quality of life (mental or physical health components), and adverse effects at follow-up after completion of the intervention were not compared to an alternative physical activity intervention.\n\nSome positive effects were observed immediately at completion of the intervention periods, but these effects were not consistent, and overall certainty of evidence was insufficient to assess the effectiveness of workplace pedometer interventions.\n ","Interventions can have positive effects on employee physical activity and health, although current evidence is insufficient to suggest that a pedometer-based intervention would be more effective than other options. \nIt is important to note that over the past decade, technological advancement in accelerometers as commercial products, often freely available in Smartphones, has in many ways rendered the use of pedometers outdated. Future studies aiming to test the impact of either pedometers or accelerometers would likely find any control arm highly contaminated. \nDecision-makers considering allocating resources to large-scale programmes of this kind should be cautious about the expected benefits of incorporating a pedometer and should note that these effects may not be sustained over the longer term. \n\nFuture studies should be designed to identify the effective components of multi-component interventions, although pedometers may not be given the highest priority (especially considering the increased availability of accelerometers). Approaches to increase the sustainability of intervention effects and behaviours over a longer term should be considered, as should more consistent measures of physical activity and health outcomes."]
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[null,"Morgan  EH et al. Caregiver involvement in interventions for improving children's dietary intake and physical activity behaviours. Cochrane Database of Systematic Reviews 2020, Issue 1. Art. No.: CD012547. DOI: 10.1002/14651858.CD012547.pub2.\nAvailable here.\n","School-aged children and their caregivers","The aim of this Cochrane review was to assess effects of caregiver involvement in interventions for improving children's dietary intake and physical activity behaviours, including those intended to prevent overweight and obesity.\nMost studies were school-based and involved the addition of healthy eating or physical education classes, or both, sometimes in tandem with other changes to the school environment. \nThe behaviour change techniques used most commonly in the child-only arm were \"shaping knowledge,\" \"comparison of behaviour,\" \"feedback and monitoring,\" and \"repetition and substitution.\" In the child + caregiver arm, the strategies used most commonly included additional \"shaping knowledge\" or \"feedback and monitoring\" techniques, as well as \"social support\" and \"natural consequences.\"\nSix studies compared physical activity interventions with and without a caregiver component. \nAt the end of the intervention, the authors did not detect a difference between intervention arms in children's total physical activity (MD 0.20 min/h, 95% CI −1.19 to 1.59, 1 study, n = 54; low quality evidence) or moderate to vigorous physical activity (MVPA) (standard mean difference [SMD] 0.04, 95% CI −0.41 to 0.49, 2 studies, n = 80; moderate-quality evidence). No trial in this comparison reported data for percentage of children's total energy intake from saturated fat, sodium intake, fruit and vegetable intake, or SSB intake, nor for adverse effects of interventions.\n","Current evidence is insufficient to support the inclusion of caregiver involvement in interventions to improve children's dietary intake or physical activity behaviour, or both. For most outcomes, the quality of the evidence is adversely impacted by the small number of studies with available data, limited effective sample sizes, risk of bias, and imprecision. \nTo establish the value of caregiver involvement, additional studies measuring clinically important outcomes using valid and reliable measures, employing appropriate design and power, and following established reporting guidelines are needed, as is evidence on how such interventions might contribute to health equity."]
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[null,"Wolfenden  L et al. Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services. Cochrane Database of Systematic Reviews 2020, Issue 2. Art. No.: CD011779. DOI: 10.1002/14651858.CD011779.pub3.\nAvailable here.\n","Staff of centre-based childcare services","The aim of this Cochrane review was to examine the effectiveness of strategies aimed at improving the implementation of policies, practices or programmes by childcare services that promote child healthy eating, physical activity and/or obesity prevention. \n\nFindings suggest that such interventions probably lead to little or no difference in child physical activity (four RCTs; moderate-certainty evidence) or weight status (three RCTs; moderate-certainty evidence).\n\nThe review findings suggest that implementation strategies probably improve the implementation of policies, practices or programmes that promote child healthy eating, physical activity and/or obesity prevention in childcare services. Of the 19 studies that compared a strategy to usual practice or minimal support control, 11 studies (nine RCTs) used score-based measures of implementation (e.g. childcare service nutrition environment score). Nine of these studies were included in pooled analysis, which found an improvement in implementation outcomes (SMD 0.49; 95% CI 0.19 to 0.79; participants = 495; moderate-certainty evidence). Ten studies (seven RCTs) used dichotomous measures of implementation (e.g. proportion of childcare services implementing a policy or specific practice), with seven of these included in pooled analysis (OR 1.83; 95% CI 0.81 to 4.11; participants = 391; low-certainty evidence)","Current research suggests that implementation strategies probably improve the implementation of policies, practices or programmes by childcare services, and may have little or no effect on measures of adverse effects. However such strategies appear to have little to no impact on measures of child diet, physical activity or weight status."]
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[null,"Ward  A, Lewis  SR, Weiss  H. Mobility management to prevent, reduce, or delay driving a car in teenagers. Cochrane Database of Systematic Reviews 2020, Issue 8. Art. No.: CD009438. DOI: 10.1002/14651858.CD009438.pub2.\nAvailable here.\n","Teenagers aged 15 to 19 years\n","The aim of this Cochrane review was to assess whether 'soft' mobility management interventions prevent, reduce, or delay car driving in teenagers aged 15 to 19 years, and to assess whether these mobility management interventions also reduce crashes caused by teenage drivers.\nThe authors included informational, educational, or behavioural interventions that aimed to prevent, reduce, or delay car driving in this age group, and we compared these interventions with no intervention or with standard practice.\nThe authors could not be certain whether interventions about active transport, given during a driving theory course, could influence behavioural predictors of car use. \nStudy authors noted: \n- an increased intention to use active transport after obtaining a driving licence between post intervention and an eight-week follow-up in students who were given an active transport lesson and a Facebook invitation compared to those given only the active transport lesson; and\n- a decrease in intention between pre- and post intervention in those given an active transport lesson and Facebook invitation compared to those given the active transport lesson only.","The authors found only two small studies, and could not determine whether mobility management interventions were effective to prevent, reduce, or delay car driving in teenagers. \nThe lack of evidence in this review raises two points. First, more foundational research is needed to discover how and why young people make decisions surrounding their personal transport, in order to find out what might encourage them to delay licensing and driving. Second, we need longitudinal studies with a robust study design – such as RCTs – and with large sample sizes that incorporate different socioeconomic groups in order to evaluate the feasibility and effectiveness of relevant interventions. Ideally, evaluations will include an assessment of how attitudes and beliefs evolve in teenagers during these transition years, and the potential effect of these on the design of a mobility management intervention for this age group."]
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[null,"Nordbø, ECA at al. Promoting activity participation and well-being among children and adolescents: a systematic review of neighbourhood built-environment determinants, JBI Evidence Synthesis: March 2020 - Volume 18 - Issue 3 - p 370-458doi: 10.11124/JBISRIR-D-19-00051.\nAvailable here.\n","Children and adolescents between five and 18 years of age","The aim of this review was to identify, evaluate, and synthesize the findings on built-environment determinants and their relation to participation in different domains of activities, including physical activity, recreational and social activities, and well-being in childhood and adolescence.\n\nThe built environment was most extensively studied in relation to the outcomes active travel (n=54) and unspecified physical activity (n=46).\nThe evidence suggests that a composite determinant of facilities and amenities is related to more unspecified physical activity. Furthermore, less traffic exposure and more safety features, pedestrian infrastructure for walking and cycling, shorter distances to facilities and greater walkability supported active travel behaviour. Fewer studies (n=11) examined the built-environment determinants of organized sports and well-being, and limited, as well as contradictory, evidence existed for the relationship between the built environment and well-being.\n","The following determinants potentially support active travel behaviour: less traffic exposure and more safety features, pedestrian infrastructure for walking and cycling, shorter distances to facilities and greater walkability. A high facility and amenity index might promote unspecified physical activity. Policies and planning\nprocesses should consider these determinants to strengthen children’s and adolescents’ health and well-being.\nHowever, there are remaining research gaps and important avenues for future research that need to be addressed before more specific and robust conclusions can be drawn."]
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[null,"Wolfenden  L et al. Strategies to improve the implementation of workplace‐based policies or practices targeting tobacco, alcohol, diet, physical activity and obesity. Cochrane Database of Systematic Reviews 2018, Issue 11. Art. No.: CD012439. DOI: 10.1002/14651858.CD012439.pub2.\nAvailable here.\n","Any workplace setting staffed by paid employees","This Cochrane review aimed to assess the effects of strategies for improving the implementation of workplace-based policies or practices targeting diet, physical activity, obesity, tobacco use and alcohol use, and to assess the impact of such strategies on employee health behaviours.\nThe authors included six trials, four of which took place in the USA.\nAll implementation interventions utilised multiple implementation strategies, the most common of which were educational meetings, tailored interventions and local consensus processes.\nThree trials examined the impact of implementation strategies on employee health behaviours, reporting mixed effects for diet and weight status (very low certainty evidence) and no effect for physical activity (very low certainty evidence) or tobacco use (low certainty evidence).","Available evidence regarding the effectiveness of implementation strategies for improving implementation of health-promoting policies and practices in the workplace setting is sparse and inconsistent. Low certainty evidence suggests that such strategies may make little or no difference on measures of implementation fidelity or different employee health behaviour outcomes. It is also unclear if such strategies are cost-effective or have potential unintended adverse consequences. The limited number of trials identified suggests implementation research in the workplace setting is in its infancy, warranting further research to guide evidence translation in this setting."]
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[null,"MacArthur  G et al. Individual‐, family‐, and school‐level interventions targeting multiple risk behaviours in young people. Cochrane Database of Systematic Reviews 2018, Issue 10. Art. No.: CD009927. DOI: 10.1002/14651858.CD009927.pub2.\nAvailable here.\n","Children and young people up to 18 years of age and/or parents, guardians, or carers","This Cochrane review aimed to examine the effects of interventions implemented up to 18 years of age for the primary or secondary prevention of multiple risk behaviours among young people.\nModerate-quality evidence showed that multiple risk behaviour universal school-based interventions improved the odds of physical activity (OR 1.32, 95% CI 1.16 to 1.50; I= 0%; n = 4 studies; 6441 participants). The authors considered observed effects to be of public health importance when applied at the population level.\n","Available evidence is strongest for universal school-based interventions that target multiple- risk behaviours, demonstrating that they may be effective in preventing engagement in tobacco use, alcohol use, illicit drug use, and antisocial behaviour, and in improving physical activity among young people, but not in preventing other risk behaviours. \n\nResults of this review do not provide strong evidence of benefit for family- or individual-level interventions across the risk behaviours studied. However, poor reporting and concerns around the quality of evidence highlight the need for high-quality multiple- risk behaviour intervention studies to further strengthen the evidence base in this field."]
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[null,"Shrestha  N et al. Workplace interventions for reducing sitting at work. Cochrane Database of Systematic Reviews 2018, Issue 12. Art. No.: CD010912. DOI: 10.1002/14651858.CD010912.pub5.\nAvailable here.\n","Employees who sit at work","This Cochrane review aimed to evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions.\nThe included studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi‐component interventions (four studies). One study included both physical workplace changes and information and counselling components.\n\nPhysical workplace changes \n\nInterventions using sit‐stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short‐term follow‐up (up to three months) compared to sit‐desks (95% CI −116 to −84, 10 studies, low‐quality evidence).\n\nWorkplace policy changes \n\nThe authors found no significant effects for implementing walking strategies on workplace sitting time at short‐term (MD −15 minutes per day, 95% CI −50 to 19, low‐quality evidence, one study) and medium‐term (MD −17 minutes/day, 95% CI −61 to 28, one study) follow‐up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI −66 to −15, one study, low‐quality evidence) compared to long breaks (two 15‐minute breaks per workday) at short‐term follow‐up.\n\nInformation and counselling \n\nProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short‐term follow‐up (MD −19 minutes per day, 95% CI −57 to 19, two studies, low‐quality evidence). However, the reduction was significant at medium‐term follow‐up (MD −28 minutes per day, 95% CI −51 to −5, two studies, low‐quality evidence).\n\nMulti‐component interventions \n\nCombining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low‐quality evidence) and on time spent in prolonged sitting bouts (two studies, very low‐quality evidence) at short‐term follow‐up.","At present there is low‐quality evidence that the use of sit‐stand desks reduce workplace sitting at short‐term and medium‐term follow‐ups. However, there is no evidence on their effects on sitting over longer follow‐up periods. \n\nEffects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi‐component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. \n\nThere is a need for larger cluster‐RCTs with longer‐term follow‐ups to determine the effectiveness of different types of interventions to reduce sitting time at work."]
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[null,"Mosdøl  A et al. Targeted mass media interventions promoting healthy behaviours to reduce risk of non‐communicable diseases in adult, ethnic minorities. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.: CD011683. DOI: 10.1002/14651858.CD011683.pub2.\nAvailable here.\n","Adults (≥ 18 years) from ethnic minority groups","This Cochrane review aimed to determine the effects of mass media interventions targeting adult ethnic minorities with messages about physical activity, dietary patterns, tobacco use or alcohol consumption to reduce the risk of NCDs.\n\nThe second comparison assessed targeted mass media interventions versus no intervention. One study (154 participants of African decent) reported effects for the primary outcomes. Participants in the intervention group had access to 12 one‐hour live programmes on cable TV and received print material over three months regarding nutrition and physical activity to improve health and weight control. Change in BMI was comparable between groups 12 months after the baseline (low quality evidence). Scores on a food habits (fat behaviours) and total leisure activity scores changed favourably for the intervention group (very low quality evidence).","It is uncertain whether, compared to no intervention, targeted mass media interventions may slightly improve physical activity and dietary patterns and BMI in the short term (based on the low quality evidence of a small effect for this outcome).\n\nThe available evidence is inadequate for understanding whether mass media interventions targeted toward ethnic minority populations are more effective in changing health behaviours than mass media interventions intended for the population at large.\nThese studies could not distinguish the impact of different components, for instance the effect of hearing a message regarding behavioural change, the cultural adaptation to the ethnic minority group, or increase reach to the target group through more appropriate mass media channels. \nNew studies should explore targeted interventions for ethnic minorities with a first language other than the dominant language in their resident country, as well as directly compare targeted versus general population mass media interventions."]
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[null,"Husk  K, et al. Participation in environmental enhancement and conservation activities for health and well‐being in adults: a review of quantitative and qualitative evidence. Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No.: CD010351. DOI: 10.1002/14651858.CD010351.pub2.\nAvailable here.\n","Adults (aged ≥ 18 years).","This Cochrane review sought to assess the health and well‐being impacts on adults following participation in environmental enhancement and conservation activities.\nThere was limited evidence that participation had positive effects on self-reported health, quality of life and physical activity levels. Some also reported increased mental fatigue and greater feelings of anxiety.","There is little quantitative evidence of positive or negative health and well‐being benefits from participating in EECA. However, the qualitative research showed high levels of perceived benefit among participants. \nQuantitative evidence resulted from study designs with high risk of bias, qualitative evidence lacked reporting detail. The majority of included studies were programme evaluations, conducted internally or funded by the provider."]
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[null,"Baker PRA et al. Community wide interventions for increasing physical activity. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No.: CD008366. DOI: 10.1002/14651858.CD008366.pub3.\nAvailable here.\n","Persons of any age residing in a geographically defined community, such as urban, peri-urban, village, town, or city.","The aim of this Cochrane review was to evaluate the effects of community wide, multi-strategic interventions upon population levels of physical activity.\n\nOne study obtained objective population representative measurements of physical activity by accelerometers, while the remaining three low-risk studies used validated self-reported measures. The study using accelerometry, conducted in low income, high crime communities of USA, emphasised social marketing, partnership with police and environmental improvements. No change in the seven-day average daily minutes of moderate to vigorous physical activity (MVPA) was observed during the two years of operation. Some program level effect was observed with more people walking in the intervention community, however this result was not evident in the whole community. Similarly, the two studies conducted in the United Kingdom (one in rural villages and the other in urban London; both using communication, partnership and environmental strategies) found no improvement in the mean levels of energy expenditure per person per week, measured from one to four years from baseline. \nNone of the three low risk studies reporting a dichotomous outcome of physical activity found improvements associated with the intervention. Overall, there was a noticeable absence of reporting of benefit in physical activity for community wide interventions in the included studies. However, as a group, the interventions undertaken in China appeared to have the greatest possibility of success with high participation rates reported. \nReporting bias was evident with two studies failing to report physical activity measured at follow up. No adverse events were reported. The data pertaining to cost and sustainability of the interventions were limited and varied.","Although numerous studies have been undertaken, there is a noticeable inconsistency of the findings in the available studies and this is confounded by serious methodological issues within the included studies. \nThe body of evidence in this review does not support the hypothesis that the multi-component community wide interventions studied effectively increased physical activity for the population, although some studies with environmental components observed more people walking."]
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[null,"Langford  R et al. The WHO Health Promoting School framework for improving the health and well‐being of students and their academic achievement. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD008958. DOI: 10.1002/14651858.CD008958.pub2.\nAvailable here.\n","Children and young people aged four to 18 years, attending schools or colleges.\n","The aim of this Cochrane review was to assess the effectiveness of the Health Promoting Schools (HPS) framework in improving the health and well-being of students and their academic achievement.\nIn this review, the authors define HPS interventions as comprising the following three elements: input to the curriculum; changes to the school’s ethos or environment or both; and engagement with families or communities, or both. The authors  compared this intervention against schools that implemented either no intervention or continued with their usual practice, or any programme that included just one or two of the above mentioned HPS elements.\nThe authors found positive effects for some interventions for: BMI, physical activity and physical fitness. Two studies (Kriemler 2010 and Simon 2006) compared physical activity only with a control, and found a small increase in physical activity levels (SMD 0.17, 95% CI: 0.16-0.5).\nIntervention effects were generally small but have the potential to produce public health benefits at the population level.","The results of this review provide evidence for the effectiveness of some interventions based on the HPS framework for improving certain health outcomes but not others. More well-designed research is required to establish the effectiveness of this approach for other health topics and academic achievement."]
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[null,"Richards  J et al. Face‐to‐face interventions for promoting physical activity. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD010392. DOI: 10.1002/14651858.CD010392.pub2.\nAvailable here.\n","Community dwelling adults (aged 16 years and above)","The aim of this Cochrane review was to compare the effectiveness of face-to-face interventions for PA promotion in community dwelling adults (aged 16 years and above) with a control exposed to placebo or no or minimal intervention.\n\nThe effect of interventions on self-reported PA at one year (eight studies; 6725 participants) was positive and moderate with significant heterogeneity (I= 74%) (SMD 0.19; 95% CI 0.06 to 0.31; moderate quality evidence) but not sustained in three studies at 24 months (4235 participants) (SMD 0.18; 95% CI -0.10 to 0.46). \nThe effect of interventions on cardiovascular fitness at one year (two studies; 349 participants) was positive and moderate with no significant heterogeneity in the observed effects (SMD 0.50; 95% CI 0.28 to 0.71; moderate quality evidence). \nThree studies (3277 participants) reported a positive effect on increasing PA levels when assessed as a dichotomous measure at 12 months, but this was not statistically significant (OR 1.52; 95% CI 0.88 to 2.61; high quality evidence). \n\nAny conclusions drawn from this review require some caution given the significant heterogeneity in the observed effects. Despite this, there was some indication that the most effective interventions were those that offered both individual and group support for changing PA levels using a tailored approach. The long-term impact, cost effectiveness and rates of adverse events for these interventions was not established because the majority of studies stopped after 12 months.","Although the authors found evidence to support the effectiveness of face-to-face interventions for promoting PA, at least at 12 months, the effectiveness of these interventions was not supported by high quality studies. \nDue to the clinical and statistical heterogeneity of the studies, only limited conclusions can be drawn about the effectiveness of individual components of the interventions. \n\nFuture studies should provide greater detail of the components of interventions, and assess impact on quality of life, adverse events and economic data."]
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[null,"Richards  J et al. Face‐to‐face versus remote and web 2.0 interventions for promoting physical activity. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD010393. DOI: 10.1002/14651858.CD010393.pub2.\nAvailable here.\n","Community dwelling adults (aged 16 years and above).","The aim of this Cochrane review was to compare the effectiveness of face-to-face versus remote and web 2.0 interventions for PA promotion in community dwelling adults (aged 16 years and above).\n\nOne study recruiting 225 apparently healthy adults met the inclusion criteria. This study took place in a high-income country. From 27,299 hits, the full texts of 193 papers were retrieved for examination against the inclusion criteria. However, there was only one paper that met the inclusion criteria. This study reported the effect of a PA intervention on cardio-respiratory fitness. There were no reported data for PA, quality of life, or cost effectiveness. The difference between the remote and web 2.0 versus face-to-face arms was not significant (SMD -0.02; 95% CI -0.30 to 0.26; high quality evidence). The risk of bias in the included study was assessed as low, and there was no evidence of an increased risk of adverse events.","Only one study met inclusion criteria.\n\nThere is insufficient evidence to assess whether face-to-face interventions or remote and web 2.0 approaches are more effective at promoting PA.\n"]
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[null,"Foster  C, Richards  J et al. Remote and web 2.0 interventions for promoting physical activity. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD010395. DOI: 10.1002/14651858.CD010395.pub2.\nAvailable here.\n","Community dwelling adults (aged 16 years and above)","The aim of this Cochrane review was to compare the effectiveness of remote and web 2.0 interventions for PA promotion in community dwelling adults (aged 16 years and above) with a control group exposed to placebo or no or minimal intervention.\nThe effect of the interventions on self-reported PA at one year (nine studies; 4547 participants) was positive and moderate (SMD 0.20; 95% CI 0.11 to 0.28; moderate quality evidence) with heterogeneity (I2 = 37%) in the observed effects. One study reported positive results at two years (SMD 0.20; 95% CI 0.08 to 0.32; moderate quality evidence).\nThe most effective interventions applied a tailored approach to the type of PA and used telephone contact to provide feedback and to support changes in PA levels. There was no evidence of an increased risk of adverse events (seven studies; 2892 participants). Risk of bias was assessed as low (eight studies; 3060 participants) or moderate (three studies; 2677 participants). \nThere were no differences in effectiveness between studies using different types of professionals delivering the intervention (for example health professional, exercise specialist). There was no difference in pooled estimates between studies that generated the prescribed PA using an automated computer programme versus a human, nor between studies that used pedometers as part of their intervention compared to studies that did not.","The authors found consistent evidence to support the effectiveness of remote and web 2.0 interventions for promoting PA. \nThese interventions have positive, moderate sized effects on increasing self-reported PA and measured cardio-respiratory fitness, at least at 12 months. \nThe effectiveness of these interventions was supported by moderate and high quality studies. However, there continues to be a paucity of cost effectiveness data and studies that include participants from varying socioeconomic or ethnic groups. To better understand the independent effect of individual programme components, longer term studies, with at least one year follow-up, are required."]
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[null,"Collins, CE et al. Effectiveness of parent-centred interventions for the prevention and treatment of childhood overweight and obesity in community settings: a systematic review, JBI Database of Systematic Reviews and Implementation Reports: September 2013 - Volume 11 - Issue 9 - p 180-257 doi: 10.11124/jbisrir-2013-709\nAvailable here.\n","Children of pre-school, primary and\nsecondary school age and/or their parents/guardians aged >18 years","The objective of this review was to identify the effectiveness of parent-centred interventions implemented in the community setting in modifying eating and physical activity behaviors or weight related outcomes of children. \n\nNineteen studies reported a physical activity or sedentary behaviour measure. The outcome measures for physical activity were more varied than for diet, with 11 different measures across the studies, including: steps per day, time spent in activity, and energy expenditure. The most common measure was the total amount of daily physical activity, commonly measured as time spent in moderate/vigorous activity (n=8 studies), total step counts/day assessed in two studies and total daily screen time measured in six studies. Two studies reported increases in the number of daily steps at 10 weeks in one study and six months in another, while two studies reported changes in screen time ranging from -1.8 hours per day to -17.5 hours per week. The majority of studies objectively measured physical activity through use of accelerometers (seven studies) all described as being worn for at least three days.","Results from the review support the after-school setting as the most promising for community\nintervention setting for targeting parents as agents of change within child obesity prevention and\ntreatment programs.\n\nImplications for practice\n\nAt this stage, interventions to support parents should target the after-school environment as opposed\nto being conducted in the home, summer camps, leisure centres or churches. Targeting a decrease\nin energy intake and sweetened beverages in parallel with increasing number of daily steps and\ndecreasing screen time use.\n"]
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[null,"Hollis, JL et al. Effectiveness of interventions using Motivational Interviewing for dietary and physical activity modification in adults: a systematic review, JBI Database of Systematic Reviews and Implementation Reports: May 2013 - Volume 11 - Issue 5 - p 1-27.\nAvailable here.\n","Participants aged 18 years or older","This review aimed to synthesize the best available evidence on the effectiveness of dietary and physical activity interventions employing MI to achieve behaviour change.\nOutcomes of interest included physical activity, including exercise or sedentary behaviors (energy expenditure, steps taken, minutes of physical activity or sitting time).\nNone of the six articles reporting on physical activity found any difference between MI and the attention control.\n","There is not yet sufficient evidence to conclude that MI enhances diet and physical activity behaviour change above an attention control, although the findings from two studies are suggestive of a positive effect in decreasing dietary fat intake.\n\nImplications for practice \n\nWhen more high quality research evidence is available, the next challenge will be to establish evidence that research-based interventions will translate to the clinical setting.\n\nImplications for research \n\nMore high quality studies that objectively measure diet and physical activity, evaluate and report fidelity scores and compare a MI intervention to an attention control over a period of at least six months are required."]

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[null,"CHILDREN AND ADOLESCENT POPULATION"]
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[null,"GUIDANCE SECTION - CHILDREN AND ADOLESCENT POPULATION"]
[null,"Source:","Audience:","Recommendations:"]
[null,"National Institute for Health and Care Excellence. Physical activity for children and young people. PH17. London: NICE; 2009 (updated 2020). \nAvailable here\n","•Children’s trusts and services, early years providers, schools and college\n•Community and voluntary groups (running sports and other organised activities)\n•Government departments\n•Local authorities (leisure and related services, transport and planning, regeneration) and local strategic partnerships\n•Organisations offering practitioners education and training\n•The police\n•Primary care trusts\n•Private sector providers\n•Children, young people, their families and carers and members of the public\n","This guideline covers promoting physical activity for children and young people aged under 18 at home, preschool, school and in the community. It includes raising awareness of the benefits of physical activity, listening to what children and young people want, planning and providing spaces and facilities, and helping families build physical activity into their daily lives.\n\nThis guideline includes recommendations on:\n•Delivering a national campaign and raising awareness about physical activity\n•Developing physical activity plans\n•Planning the provision of spaces and facilities\n•Responding to what children and young people want\n•Multi-component school and community programmes\n•Active and sustainable school travel plans\n•Helping children and families to be active\n"]
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[null,"National Institute for Health and Care Excellence. Physical activity: walking and cycling. PH41. London: NICE; 2012. \nAvailable here.\n","•Commissioners, managers and practitioners\n•Members of the public\n","This guideline covers encouraging people to increase the amount they walk or cycle for travel or recreation purposes.\n\nThis guideline includes recommendations on:\n•Policy and planning\n•Local programmes\n•Schools, workplaces and the NHS"]
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[null,"SYSTEMATIC REVIEWS - CHILDREN AND ADOLESCENT POPULATION"]
[null,"Source:","Population:","Findings:","Authors' Conclusions:"]
[null,"Neil-Sztramko  SE, Caldwell  H, Dobbins  M. School‐based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database of Systematic Reviews 2021, Issue 9. Art. No.: CD007651. DOI: 10.1002/14651858.CD007651.pub3.\nAvailable here","School-attending children and adolescents between the ages of 6 and 18 years.","Results show that school‐based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate‐certainty evidence) and may lead to little to no decrease in sedentary time (MD ‐3.78 minutes/d, 95% CI ‐7.80 to 0.24; 16 studies; low‐certainty evidence). \nSchool‐based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low‐certainty evidence). School‐based physical activity interventions may result in a very small decrease in BMI z‐scores (MD ‐0.06, 95% CI ‐0.09 to ‐0.02; 21 studies; low‐certainty evidence) and may not impact BMI expressed as kg/m² (MD ‐0.07, 95% CI ‐0.15 to 0.01; 50 studies; low‐certainty evidence).\n","Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school‐based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously."]
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[null,"Virgara  R, et al. Interventions in outside‐school hours childcare settings for promoting physical activity amongst schoolchildren aged 4 to 12 years. Cochrane Database of Systematic Reviews 2021, Issue 9. Art. No.: CD013380. DOI: 10.1002/14651858.CD013380.pub2.\nAvailable here\n","Children aged 4 to 12 years in outside‐school hours childcare settings.","This review sought to assess the effectiveness, cost-effectiveness and associated adverse events of interventions designed to increase physical activity in children aged 4 to 12 years in outside-school hours childcare settings.\nThere was low-certainty evidence that physical activity interventions may have little to no effect on total daily moderate-to-vigorous physical activity compared to no intervention (MD 1.7 minutes, 95% CI –0.42 to 3.82; P = 0.12; 6 trials; 3042 children). The authors were unable to pool data on proportion of the OSHC session spent in moderate-to-vigorous physical activity in a meta-analysis. Both trials showed an increase in proportion of session spent in moderate-to-vigorous physical activity (moderate-certainty evidence) from 4% to 7.3% of session time; however, only one trial was statistically significant. \nThere was low-certainty evidence that physical activity interventions may lead to little to no reduction in body mass index (BMI) as a measure of cardiovascular health, compared to no intervention (SMD –0.17, 95%CI –0.44 to 0.10; P = 0.22; 4 trials, 1684 children). \nPhysical activity interventions that were delivered online were more cost-effective than in person. Combined results suggest that staff-and-parent and staff-and-child-based interventions may lead to a small increase in overall daily physical activity and a small reduction or no difference in BMI. \nProcess evaluation was assessed differently by four of the included studies, with two studies reporting improvements in physical activity practices, one reporting high programme satisfaction and one high programme fidelity. The certainty of the evidence for these outcomes was low to moderate. Finally, there was very low-certainty evidence that physical activity interventions in outside-school hours childcare settings may increase cardiovascular fitness.\n","Although the review included nine trials, the evidence for how to increase children's physical activity in outside-school hours care settings remains limited, both in terms of certainty of evidence and magnitude of the effect. \nOf the types of interventions identified, when assessed using GRADE there was low-certainty evidence that multi-component interventions, with a specific physical activity goal may have as mall increase in daily moderate-to-vigorous physical activity and a slight reduction in BMI. \nThere was very low-certainty evidence that interventions increase cardiovascular fitness. By contrast there was moderate-certainty evidence that interventions were effective for increasing proportion of time spent in moderate-to-vigorous physical activity, and online training is cost-effective.\n"]
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[null,"Morgan  EH et al. Caregiver involvement in interventions for improving children's dietary intake and physical activity behaviours. Cochrane Database of Systematic Reviews 2020, Issue 1. Art. No.: CD012547. DOI: 10.1002/14651858.CD012547.pub2.\nAvailable here.\n","School-aged children and their caregivers","The aim of this Cochrane review was to assess effects of caregiver involvement in interventions for improving children's dietary intake and physical activity behaviours, including those intended to prevent overweight and obesity.\nMost studies were school-based and involved the addition of healthy eating or physical education classes, or both, sometimes in tandem with other changes to the school environment. \nThe behaviour change techniques used most commonly in the child-only arm were \"shaping knowledge,\" \"comparison of behaviour,\" \"feedback and monitoring,\" and \"repetition and substitution.\" In the child + caregiver arm, the strategies used most commonly included additional \"shaping knowledge\" or \"feedback and monitoring\" techniques, as well as \"social support\" and \"natural consequences.\"\nSix studies compared physical activity interventions with and without a caregiver component. \nAt the end of the intervention, the authors did not detect a difference between intervention arms in children's total physical activity (MD 0.20 min/h, 95% CI −1.19 to 1.59, 1 study, n = 54; low quality evidence) or moderate to vigorous physical activity (MVPA) (standard mean difference [SMD] 0.04, 95% CI −0.41 to 0.49, 2 studies, n = 80; moderate-quality evidence). No trial in this comparison reported data for percentage of children's total energy intake from saturated fat, sodium intake, fruit and vegetable intake, or SSB intake, nor for adverse effects of interventions.\n","Current evidence is insufficient to support the inclusion of caregiver involvement in interventions to improve children's dietary intake or physical activity behaviour, or both. For most outcomes, the quality of the evidence is adversely impacted by the small number of studies with available data, limited effective sample sizes, risk of bias, and imprecision. \nTo establish the value of caregiver involvement, additional studies measuring clinically important outcomes using valid and reliable measures, employing appropriate design and power, and following established reporting guidelines are needed, as is evidence on how such interventions might contribute to health equity."]
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[null,"Wolfenden  L et al. Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services. Cochrane Database of Systematic Reviews 2020, Issue 2. Art. No.: CD011779. DOI: 10.1002/14651858.CD011779.pub3.\nAvailable here.","Staff of centre-based childcare services\n","The aim of this Cochrane review was to examine the effectiveness of strategies aimed at improving the implementation of policies, practices or programmes by childcare services that promote child healthy eating, physical activity and/or obesity prevention. \n\nFindings suggest that such interventions probably lead to little or no difference in child physical activity (four RCTs; moderate-certainty evidence) or weight status (three RCTs; moderate-certainty evidence).\n\nThe review findings suggest that implementation strategies probably improve the implementation of policies, practices or programmes that promote child healthy eating, physical activity and/or obesity prevention in childcare services. Of the 19 studies that compared a strategy to usual practice or minimal support control, 11 studies (nine RCTs) used score-based measures of implementation (e.g. childcare service nutrition environment score). Nine of these studies were included in pooled analysis, which found an improvement in implementation outcomes (SMD 0.49; 95% CI 0.19 to 0.79; participants = 495; moderate-certainty evidence). Ten studies (seven RCTs) used dichotomous measures of implementation (e.g. proportion of childcare services implementing a policy or specific practice), with seven of these included in pooled analysis (OR 1.83; 95% CI 0.81 to 4.11; participants = 391; low-certainty evidence).","Current research suggests that implementation strategies probably improve the implementation of policies, practices or programmes by childcare services, and may have little or no effect on measures of adverse effects. However such strategies appear to have little to no impact on measures of child diet, physical activity or weight status."]
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[null,"Ward  A, Lewis  SR, Weiss  H. Mobility management to prevent, reduce, or delay driving a car in teenagers. Cochrane Database of Systematic Reviews 2020, Issue 8. Art. No.: CD009438. DOI: 10.1002/14651858.CD009438.pub2.\nAvailable here.","Teenagers aged 15 to 19 years\n","The aim of this Cochrane review was to assess whether 'soft' mobility management interventions prevent, reduce, or delay car driving in teenagers aged 15 to 19 years, and to assess whether these mobility management interventions also reduce crashes caused by teenage drivers.\nThe authors included informational, educational, or behavioural interventions that aimed to prevent, reduce, or delay car driving in this age group, and we compared these interventions with no intervention or with standard practice.\nThe authors could not be certain whether interventions about active transport, given during a driving theory course, could influence behavioural predictors of car use. \nStudy authors noted: \n- an increased intention to use active transport after obtaining a driving licence between post intervention and an eight-week follow-up in students who were given an active transport lesson and a Facebook invitation compared to those given only the active transport lesson; and\n- a decrease in intention between pre- and post intervention in those given an active transport lesson and Facebook invitation compared to those given the active transport lesson only.\n","The authors found only two small studies, and could not determine whether mobility management interventions were effective to prevent, reduce, or delay car driving in teenagers. \nThe lack of evidence in this review raises two points. First, more foundational research is needed to discover how and why young people make decisions surrounding their personal transport, in order to find out what might encourage them to delay licensing and driving. Second, we need longitudinal studies with a robust study design – such as RCTs – and with large sample sizes that incorporate different socioeconomic groups in order to evaluate the feasibility and effectiveness of relevant interventions. Ideally, evaluations will include an assessment of how attitudes and beliefs evolve in teenagers during these transition years, and the potential effect of these on the design of a mobility management intervention for this age group."]
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[null,"Nordbø, ECA at al. Promoting activity participation and well-being among children and adolescents: a systematic review of neighbourhood built-environment determinants, JBI Evidence Synthesis: March 2020 - Volume 18 - Issue 3 - p 370-458doi: 10.11124/JBISRIR-D-19-00051.\nAvailable here.\n","Children and adolescents between five and 18 years of age.\n\n","The aim of this review was to identify, evaluate, and synthesize the findings on built-environment determinants and their relation to participation in different domains of activities, including physical activity, recreational and social activities, and well-being in childhood and adolescence.\n\nThe built environment was most extensively studied in relation to the outcomes active travel (n=54) and unspecified physical activity (n=46).\nThe evidence suggests that a composite determinant of facilities and amenities is related to more unspecified physical activity. Furthermore, less traffic exposure and more safety features, pedestrian infrastructure for walking and cycling, shorter distances to facilities and greater walkability supported active travel behavior. Fewer studies (n=11) examined the built-environment determinants of organized sports and well-being, and limited, as well as contradictory, evidence existed for the relationship between the built environment and well-being.\n","The following determinants potentially support active travel behavior: less traffic exposure and more safety features, pedestrian infrastructure for walking and cycling, shorter distances to facilities and greater walkability. A high facility and amenity index might promote unspecified physical activity. Policies and planning\nprocesses should consider these determinants to strengthen children’s and adolescents’ health and well-being.\nHowever, there are remaining research gaps and important avenues for future research that need to be addressed before more specific and robust conclusions can be drawn.\n "]
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[null,"MacArthur  G et al. Individual‐, family‐, and school‐level interventions targeting multiple risk behaviours in young people. Cochrane Database of Systematic Reviews 2018, Issue 10. Art. No.: CD009927. DOI: 10.1002/14651858.CD009927.pub2.\nAvailable here.","Children and young people up to 18 years of age and/or parents, guardians, or carers","This Cochrane review aimed to examine the effects of interventions implemented up to 18 years of age for the primary or secondary prevention of multiple risk behaviours among young people.\nModerate-quality evidence showed that multiple risk behaviour universal school-based interventions improved the odds of physical activity (OR 1.32, 95% CI 1.16 to 1.50; I= 0%; n = 4 studies; 6441 participants). The authors considered observed effects to be of public health importance when applied at the population level.\n","Available evidence is strongest for universal school-based interventions that target multiple- risk behaviours, demonstrating that they may be effective in preventing engagement in tobacco use, alcohol use, illicit drug use, and antisocial behaviour, and in improving physical activity among young people, but not in preventing other risk behaviours. \n\nResults of this review do not provide strong evidence of benefit for family- or individual-level interventions across the risk behaviours studied. However, poor reporting and concerns around the quality of evidence highlight the need for high-quality multiple- risk behaviour intervention studies to further strengthen the evidence base in this field."]
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[null,"Langford  R et al. The WHO Health Promoting School framework for improving the health and well‐being of students and their academic achievement. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD008958. DOI: 10.1002/14651858.CD008958.pub2.\nAvailable here.","Children and young people aged four to 18 years, attending schools or colleges.\n","The aim of this Cochrane review was to assess the effectiveness of the Health Promoting Schools (HPS) framework in improving the health and well-being of students and their academic achievement.\nIn this review, the authors define HPS interventions as comprising the following three elements: input to the curriculum; changes to the school’s ethos or environment or both; and engagement with families or communities, or both. The authors  compared this intervention against schools that implemented either no intervention or continued with their usual practice, or any programme that included just one or two of the above mentioned HPS elements.\nThe authors found positive effects for some interventions for: body mass index (BMI), physical activity and physical fitness. Two studies (Kriemler 2010 and Simon 2006) compared physical activity only with a control, and found a small increase in physical activity levels (SMD 0.17, 95% CI: 0.16-0.5).\nIntervention effects were generally small but have the potential to produce public health benefits at the population level.\n\n","The results of this review provide evidence for the effectiveness of some interventions based on the HPS framework for improving certain health outcomes but not others. More well-designed research is required to establish the effectiveness of this approach for other health topics and academic achievement."]
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[null,"Collins, CE et al. Effectiveness of parent-centred interventions for the prevention and treatment of childhood overweight and obesity in community settings: a systematic review, JBI Database of Systematic Reviews and Implementation Reports: September 2013 - Volume 11 - Issue 9 - p 180-257 doi: 10.11124/jbisrir-2013-709\nAvailable here.","Children of pre-school, primary and\nsecondary school age and/or their parents/guardians aged >18 years.","The objective of this review was to identify the effectiveness of parent-centred interventions implemented in the community setting in modifying eating and physical activity behaviors or weight related outcomes of children. \n\nNineteen studies reported a physical activity or sedentary behavior measure. The outcome measures for physical activity were more varied than for diet, with 11 different measures across the studies, including: steps per day, time spent in activity, and energy expenditure. The most common measure was the total amount of daily physical activity, commonly measured as time spent in moderate/vigorous activity (n=8 studies), total step counts/day assessed in two studies and total daily screen time measured in six studies. Two studies reported increases in the number of daily steps at 10 weeks in one study and six months in another, while two studies reported changes in screen time ranging from -1.8 hours per day to -17.5 hours per week. The majority of studies objectively measured physical activity through use of accelerometers (seven studies) all described as being worn for at least three days.\n","Results from the review support the after-school setting as the most promising for community\nintervention setting for targeting parents as agents of change within child obesity prevention and\ntreatment programs.\n\nImplications for practice:\n\nAt this stage, interventions to support parents should target the after-school environment as opposed\nto being conducted in the home, summer camps, leisure centres or churches. Targeting a decrease\nin energy intake and sweetened beverages in parallel with increasing number of daily steps and\ndecreasing screen time use.\n"]

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[null,"ADULT POPULATION"]
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[null,"GUIDANCE - ADULT POPULATION"]
[null,"Source:","Audience:","Recommendations:"]
[null,"National Institute for Health and Care Excellence. Behaviour change: digital and mobile health interventions. NG183. London: NICE; 2020.\nAvailable here","•Local policy makers and commissioners\n•Individuals, groups or organisations wishing to work or working with health and social care service providers\n•Designers and providers of digital and mobile health interventions and programmes\n•Behaviour change practitioners\n•Trained staff working in health and social care services who have contact with the general public\n•People who want to improve their health-related behaviours (concerning diet and physical activity, smoking, alcohol use and safer sex), their families or carers, and other members of the public","This guideline covers interventions that use a digital or mobile platform to help people eat more healthily, become more active, stop smoking, reduce their alcohol intake or practise safer sex. The interventions include those delivered by text message, apps, wearable devices or the internet. The guideline only includes those that are delivered by the technology itself and not by healthcare professionals using technology to deliver interventions.\n\nThis guideline includes recommendations on:\n•Developing digital and mobile health interventions\n•Commissioning digital and mobile health interventions\n•Using digital and mobile health interventions\n•Interventions for diet and physical activity\n"]
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[null,"National Institute for Health and Care Excellence. Community pharmacies: promoting health and wellbeing. NG102. London: NICE; 2018. \nAvailable here","•Community pharmacies, local pharmaceutical committees and pharmacy organisations\n•Commissioners of health-promoting interventions including local authorities, clinical commissioning groups and NHS England\n•Local professional networks (hosted by NHS England)\n•Health and wellbeing boards\n","This guideline covers how community pharmacies can help maintain and improve people’s physical and mental health and wellbeing, including people with a long-term condition. It aims to encourage more people to use community pharmacies by integrating them within existing health and care pathways and ensuring they offer standard services and a consistent approach. It requires a collaborative approach from individual pharmacies and their representatives, local authorities and other commissioners\n\nThis guideline includes recommendations on:\n•Health and wellbeing hub\n•Overarching principles of good practice\n•Awareness raising and providing information\n•Advice and education\n•Behavioural support\n•Referrals and signposting\n"]
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[null,"National Institute for Health and Care Excellence. Behaviour change: general approaches. PH6. London: NICE; 2017. \nLast updated: 2017\nAvailable here.\n\nUnderpinning evidence review here.\n\n\n","•National policy makers, commissioners, providers and practitioners in the NHS, local authorities and the community and voluntary sectors\n•Researchers, including those who oversee research funding\n•Social and behavioural scientists\n•Health economists working on health-related knowledge, attitude and behaviour change\n","This guideline covers a set of principles that can be used to help people change their behaviour. The aim is for practitioners to use these principles to encourage people to adopt a healthier lifestyle by, for example, stopping smoking, adopting a healthy diet and being more physically active.\n\nThis guideline recommends a set of principles to use as the basis for:\n•Providing education and training for those delivering them\n•Delivery of these activities, including one-to-one and community-based programmes and those aimed at specific populations\n•Evaluation of their effectiveness and cost effectiveness\n"]
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[null,"National Institute for Health and Care Excellence. Physical activity: exercise referral schemes. PH54. London: NICE; 2014. \nAvailable here.\n\nUnderpinning evidence review here. \n\n\n","•Policy makers and commissioners in local authorities and the NHS\n•Primary care practitioners and other practitioners with physical activity as part of their remit\n•Providers of exercise referral schemes\n•Organisations that provide exercise qualifications and accreditation\n•Members of the public\n","This guideline covers exercise referral schemes for people aged 19 and older, in particular, those who are inactive or sedentary. The aim is to encourage people to be physically active.\n\nThis guideline includes recommendations on:\n•Exercise referral for people who are sedentary or inactive but otherwise healthy\n•Exercise referral for people who are sedentary or inactive and have a health condition or other health risk factors"]
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[null,"National Institute for Health and Care Excellence. Behaviour change: individual approaches. PH49. London: NICE; 2014. \nAvailable here.\n","•Healthcare professionals\n•Commissioners and providers\n•Young people and adults, and their families and carers\n","This guideline covers changing health-damaging behaviours among people aged 16 and over using interventions such as goals and planning, feedback and monitoring, and social support. It aims to help tackle a range of behaviours including alcohol misuse, poor eating patterns, lack of physical activity, unsafe sexual behaviour and smoking.\n\nThis guideline includes recommendations on:\n•Developing local behaviour change policy and strategy\n•Commissioning interventions\n•Planning interventions that take account of local needs\n•Ensuring interventions meet individual needs\n•Delivering interventions\n•Commissioning and providing training\n•Monitoring and evaluating interventions\n"]
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[null,"National Institute for Health and Care Excellence. Physical activity: brief advice for adults in primary care. PH44. London: NICE; 2013.\nAvailable here.\n\nUnderpinning evidence review here.\n\n\n","•Commissioners and practitioners\n•Members of the public\n","This guideline covers providing brief advice on physical activity to adults in primary care. It aims to improve health and wellbeing by raising awareness of the importance of physical activity and encouraging people to increase or maintain their activity level.\n\nThis guideline includes recommendations on:\n•Identifying adults who are inactive\n•Delivering and following up on brief advice\n•Incorporating brief advice in commissioning\n•Systems to support brief advice\n•Providing information and training\n"]
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[null,"National Institute for Health and Care Excellence. Physical activity: walking and cycling. PH41. London: NICE; 2012. \nAvailable here.\n","•Commissioners, managers and practitioners\n•Members of the public\n","This guideline covers encouraging people to increase the amount they walk or cycle for travel or recreation purposes.\n\nThis guideline includes recommendations on:\n•Policy and planning\n•Local programmes\n•Schools, workplaces and the NHS\n"]
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[null,"National Institute for Health and Care Excellence. Mental wellbeing in over 65s: occupational therapy and physical activity interventions. PH16. London: NICE; 2008.\nAvailable here.\n\nNOTE: Recommendation 2 was updated 2020 and has been included; other recommendations and the guidance as a whole are older than 10 years. ","Older people and their carers","This guideline covers promoting mental wellbeing in people aged over 65. It focuses on practical support for everyday activities, based on occupational therapy principles and methods. This includes working with older people and their carers to agree what kind of support they need.\n\nRecommendation 2 is aimed at:\n-Physiotherapists, registered exercise professionals and fitness instructors and other health, social care, leisure services and voluntary sector staff who have the qualifications, skills and experience to deliver exercise programmes appropriate for older people.\n\nRecommendation 2 suggests:\n-In collaboration with older people and their carers, offer tailored exercise and physical activity programmes in the community"]
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[null,"SYSTEMATIC REVIEWS - ADULT POPULATION"]
[null,"Source:","Population:","Findings:","Authors' Conclusions:"]
[null,"Freak-Poli  RLA et al. Workplace pedometer interventions for increasing physical activity. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No.: CD009209. DOI: 10.1002/14651858.CD009209.pub3.\nAvailable here.\n","Both healthy populations and those at risk of chronic disease (e.g. through inactivity or overweight), with a mean age of 41 years.","This Cochrane review sought to assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving long-term health outcomes.\n\nWhen pedometer interventions are compared to minimal interventions at follow-up points at least one month after completion of their intervention, pedometers may have no effect on physical activity (6 studies; very low-certainty evidence; no meta-analysis due to very high heterogeneity), but the effect is very uncertain. \n\nPedometers may have effects on sedentary behaviour and on quality of life (mental health component), but these effects were very uncertain (1 study; very low-certainty evidence).\n\nPedometer interventions may slightly reduce anthropometry (body mass index (BMI) -0.64, 95% confidence interval (CI) -1.45 to 0.18; 3studies; low-certainty evidence). \n\nPedometer interventions probably had little to no effect on blood pressure (systolic: -0.08 mmHg, 95%CI -3.26 to 3.11; 2 studies; moderate-certainty evidence) and may have reduced adverse effects (such as injuries; from 24 to 10 per 100 people in populations experiencing relatively frequent events; odds ratio (OR) 0.50, 95% CI 0.30 to 0.84; low-certainty evidence). \n\nNo studies compared biochemical measures or disease risk scores at follow-up after completion of the intervention versus a minimal intervention. \n\nComparison of pedometer interventions to alternative physical activity interventions at follow-up points at least one month after completion of the intervention revealed that pedometers may have an effect on physical activity, but the effect is very uncertain (1 study; very low-certainty evidence). \n\nSedentary behaviour, anthropometry (BMI or waist circumference), blood pressure (systolic or diastolic),biochemistry (low-density lipoprotein (LDL) cholesterol, total cholesterol, or triglycerides), disease risk scores, quality of life (mental or physical health components), and adverse effects at follow-up after completion of the intervention were not compared to an alternative physical activity intervention.\n\nSome positive effects were observed immediately at completion of the intervention periods, but these effects were not consistent, and overall certainty of evidence was insufficient to assess the effectiveness of workplace pedometer interventions.\n ","Interventions can have positive effects on employee physical activity and health, although current evidence is insufficient to suggest that a pedometer-based intervention would be more effective than other options. \nIt is important to note that over the past decade, technological advancement in accelerometers as commercial products, often freely available in Smartphones, has in many ways rendered the use of pedometers outdated. Future studies aiming to test the impact of either pedometers or accelerometers would likely find any control arm highly contaminated. \nDecision-makers considering allocating resources to large-scale programmes of this kind should be cautious about the expected benefits of incorporating a pedometer and should note that these effects may not be sustained over the longer term. \nFuture studies should be designed to identify the effective components of multi-component interventions, although pedometers may not be given the highest priority (especially considering the increased availability of accelerometers). Approaches to increase the sustainability of intervention effects and behaviours over a longer term should be considered, as should more consistent measures of physical activity and health outcomes."]
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[null,"Wolfenden  L et al. Strategies to improve the implementation of workplace‐based policies or practices targeting tobacco, alcohol, diet, physical activity and obesity. Cochrane Database of Systematic Reviews 2018, Issue 11. Art. No.: CD012439. DOI: 10.1002/14651858.CD012439.pub2.\nAvailable here.\n","Any workplace setting staffed by paid employees. ","This Cochrane review aimed to assess the effects of strategies for improving the implementation of workplace-based policies or practices targeting diet, physical activity, obesity, tobacco use and alcohol use, and to assess the impact of such strategies on employee health behaviours.\nThe authors included six trials, four of which took place in the USA.\nAll implementation interventions utilised multiple implementation strategies, the most common of which were educational meetings, tailored interventions and local consensus processes.\nThree trials examined the impact of implementation strategies on employee health behaviours, reporting mixed effects for diet and weight status (very low certainty evidence) and no effect for physical activity (very low certainty evidence) or tobacco use (low certainty evidence).","Available evidence regarding the effectiveness of implementation strategies for improving implementation of health-promoting policies and practices in the workplace setting is sparse and inconsistent. Low certainty evidence suggests that such strategies may make little or no difference on measures of implementation fidelity or different employee health behaviour outcomes. It is also unclear if such strategies are cost-effective or have potential unintended adverse consequences. The limited number of trials identified suggests implementation research in the workplace setting is in its infancy, warranting further research to guide evidence translation in this setting."]
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[null,"Shrestha  N et al. Workplace interventions for reducing sitting at work. Cochrane Database of Systematic Reviews 2018, Issue 12. Art. No.: CD010912. DOI: 10.1002/14651858.CD010912.pub5.\nAvailable here.\n","Employees who sit at work","This Cochrane review aimed to evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions.\nThe included studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi‐component interventions (four studies). One study included both physical workplace changes and information and counselling components.\n\nPhysical workplace changes \n\nInterventions using sit‐stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short‐term follow‐up (up to three months) compared to sit‐desks (95% confidence interval (CI) −116 to −84, 10 studies, low‐quality evidence).\n\nWorkplace policy changes \n\nThe authors found no significant effects for implementing walking strategies on workplace sitting time at short‐term (MD −15 minutes per day, 95% CI −50 to 19, low‐quality evidence, one study) and medium‐term (MD −17 minutes/day, 95% CI −61 to 28, one study) follow‐up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI −66 to −15, one study, low‐quality evidence) compared to long breaks (two 15‐minute breaks per workday) at short‐term follow‐up.\n\nInformation and counselling \n\nProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short‐term follow‐up (MD −19 minutes per day, 95% CI −57 to 19, two studies, low‐quality evidence). However, the reduction was significant at medium‐term follow‐up (MD −28 minutes per day, 95% CI −51 to −5, two studies, low‐quality evidence).\n\nMulti‐component interventions \n\nCombining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low‐quality evidence) and on time spent in prolonged sitting bouts (two studies, very low‐quality evidence) at short‐term follow‐up.","At present there is low‐quality evidence that the use of sit‐stand desks reduce workplace sitting at short‐term and medium‐term follow‐ups. However, there is no evidence on their effects on sitting over longer follow‐up periods. \n\nEffects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi‐component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. \n\nThere is a need for larger cluster‐RCTs with longer‐term follow‐ups to determine the effectiveness of different types of interventions to reduce sitting time at work."]
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[null,"Mosdøl  A et al. Targeted mass media interventions promoting healthy behaviours to reduce risk of non‐communicable diseases in adult, ethnic minorities. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.: CD011683. DOI: 10.1002/14651858.CD011683.pub2.\nAvailable here.","Adults (≥ 18 years) from ethnic minority groups.","This Cochrane review aimed to determine the effects of mass media interventions targeting adult ethnic minorities with messages about physical activity, dietary patterns, tobacco use or alcohol consumption to reduce the risk of NCDs.\n\nThe second comparison assessed targeted mass media interventions versus no intervention. One study (154 participants of African decent) reported effects for the primary outcomes. Participants in the intervention group had access to 12 one‐hour live programmes on cable TV and received print material over three months regarding nutrition and physical activity to improve health and weight control. Change in body mass index (BMI) was comparable between groups 12 months after the baseline (low quality evidence). Scores on a food habits (fat behaviours) and total leisure activity scores changed favourably for the intervention group (very low quality evidence).","It is uncertain whether, compared to no intervention, targeted mass media interventions may slightly improve physical activity and dietary patterns and BMI in the short term (based on the low quality evidence of a small effect for this outcome).\n\nThe available evidence is inadequate for understanding whether mass media interventions targeted toward ethnic minority populations are more effective in changing health behaviours than mass media interventions intended for the population at large.\nThese studies could not distinguish the impact of different components, for instance the effect of hearing a message regarding behavioural change, the cultural adaptation to the ethnic minority group, or increase reach to the target group through more appropriate mass media channels. \nNew studies should explore targeted interventions for ethnic minorities with a first language other than the dominant language in their resident country, as well as directly compare targeted versus general population mass media interventions."]
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[null,"Husk  K, et al. Participation in environmental enhancement and conservation activities for health and well‐being in adults: a review of quantitative and qualitative evidence. Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No.: CD010351. DOI: 10.1002/14651858.CD010351.pub2.\nAvailable here.","Adults (aged ≥ 18 years).","This Cochrane review sought to assess the health and well‐being impacts on adults following participation in environmental enhancement and conservation activities.\nThere was limited evidence that participation had positive effects on self-reported health, quality of life and physical activity levels. Some also reported increased mental fatigue and greater feelings of anxiety.\n","There is little quantitative evidence of positive or negative health and well‐being benefits from participating in EECA. However, the qualitative research showed high levels of perceived benefit among participants. \nQuantitative evidence resulted from study designs with high risk of bias, qualitative evidence lacked reporting detail. The majority of included studies were programme evaluations, conducted internally or funded by the provider."]
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[null,"Baker PRA et al. Community wide interventions for increasing physical activity. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No.: CD008366. DOI: 10.1002/14651858.CD008366.pub3.\nAvailable here.\n","Persons of any age residing in a geographically defined community, such as urban, peri-urban, village, town, or city.","The aim of this Cochrane review was to evaluate the effects of community wide, multi-strategic interventions upon population levels of physical activity.\n\nOne study obtained objective population representative measurements of physical activity by accelerometers, while the remaining three low-risk studies used validated self-reported measures. The study using accelerometry, conducted in low income, high crime communities of USA, emphasised social marketing, partnership with police and environmental improvements. No change in the seven-day average daily minutes of moderate to vigorous physical activity was observed during the two years of operation. Some program level effect was observed with more people walking in the intervention community, however this result was not evident in the whole community. Similarly, the two studies conducted in the United Kingdom (one in rural villages and the other in urban London; both using communication, partnership and environmental strategies) found no improvement in the mean levels of energy expenditure per person per week, measured from one to four years from baseline. \nNone of the three low risk studies reporting a dichotomous outcome of physical activity found improvements associated with the intervention. Overall, there was a noticeable absence of reporting of benefit in physical activity for community wide interventions in the included studies. However, as a group, the interventions undertaken in China appeared to have the greatest possibility of success with high participation rates reported. \nReporting bias was evident with two studies failing to report physical activity measured at follow up. No adverse events were reported. The data pertaining to cost and sustainability of the interventions were limited and varied.","Although numerous studies have been undertaken, there is a noticeable inconsistency of the findings in the available studies and this is confounded by serious methodological issues within the included studies. \nThe body of evidence in this review does not support the hypothesis that the multi-component community wide interventions studied effectively increased physical activity for the population, although some studies with environmental components observed more people walking."]
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[null,"Foster  C, Richards  J et al. Remote and web 2.0 interventions for promoting physical activity. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD010395. DOI: 10.1002/14651858.CD010395.pub2.\nAvailable here.\n","Community dwelling adults (aged 16 years and above)","The aim of this Cochrane review was to compare the effectiveness of remote and web 2.0 interventions for PA promotion in community dwelling adults (aged 16 years and above) with a control group exposed to placebo or no or minimal intervention.\nThe effect of the interventions on self-reported PA at one year (nine studies; 4547 participants) was positive and moderate (SMD 0.20; 95% CI 0.11 to 0.28; moderate quality evidence) with heterogeneity (I2 = 37%) in the observed effects. One study reported positive results at two years (SMD 0.20; 95% CI 0.08 to 0.32; moderate quality evidence).\nThe most effective interventions applied a tailored approach to the type of PA and used telephone contact to provide feedback and to support changes in PA levels. There was no evidence of an increased risk of adverse events (seven studies; 2892 participants). Risk of bias was assessed as low (eight studies; 3060 participants) or moderate (three studies; 2677 participants). \nThere were no differences in effectiveness between studies using different types of professionals delivering the intervention (for example health professional, exercise specialist). There was no difference in pooled estimates between studies that generated the prescribed PA using an automated computer programme versus a human, nor between studies that used pedometers as part of their intervention compared to studies that did not.","The authors found consistent evidence to support the effectiveness of remote and web 2.0 interventions for promoting PA. \nThese interventions have positive, moderate sized effects on increasing self-reported PA and measured cardio-respiratory fitness, at least at 12 months. \nThe effectiveness of these interventions was supported by moderate and high quality studies. However, there continues to be a paucity of cost effectiveness data and studies that include participants from varying socioeconomic or ethnic groups. To better understand the independent effect of individual programme components, longer term studies, with at least one year follow-up, are required."]
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[null,"Richards  J et al. Face‐to‐face interventions for promoting physical activity. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD010392. DOI: 10.1002/14651858.CD010392.pub2.\nAvailable here.","Community dwelling adults (aged 16 years and above)","The aim of this Cochrane review was to compare the effectiveness of face-to-face interventions for PA promotion in community dwelling adults (aged 16 years and above) with a control exposed to placebo or no or minimal intervention.\n\nThe effect of interventions on self-reported PA at one year (eight studies; 6725 participants) was positive and moderate with significant heterogeneity (I= 74%) (SMD 0.19; 95% CI 0.06 to 0.31; moderate quality evidence) but not sustained in three studies at 24 months (4235 participants) (SMD 0.18; 95% CI -0.10 to 0.46). \nThe effect of interventions on cardiovascular fitness at one year (two studies; 349 participants) was positive and moderate with no significant heterogeneity in the observed effects (SMD 0.50; 95% CI 0.28 to 0.71; moderate quality evidence). \nThree studies (3277 participants) reported a positive effect on increasing PA levels when assessed as a dichotomous measure at 12 months, but this was not statistically significant (OR 1.52; 95% CI 0.88 to 2.61; high quality evidence). \n\nAny conclusions drawn from this review require some caution given the significant heterogeneity in the observed effects. Despite this, there was some indication that the most effective interventions were those that offered both individual and group support for changing PA levels using a tailored approach. The long-term impact, cost effectiveness and rates of adverse events for these interventions was not established because the majority of studies stopped after 12 months.","Although the authors found evidence to support the effectiveness of face-to-face interventions for promoting PA, at least at 12 months, the effectiveness of these interventions was not supported by high quality studies. \nDue to the clinical and statistical heterogeneity of the studies, only limited conclusions can be drawn about the effectiveness of individual components of the interventions. \n\nFuture studies should provide greater detail of the components of interventions, and assess impact on quality of life, adverse events and economic data."]
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[null,"Richards  J et al. Face‐to‐face versus remote and web 2.0 interventions for promoting physical activity. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD010393. DOI: 10.1002/14651858.CD010393.pub2.\nAvailable here.\n","Community dwelling adults (aged 16 years and above).","The aim of this Cochrane review was to compare the effectiveness of face-to-face versus remote and web 2.0 interventions for PA promotion in community dwelling adults (aged 16 years and above).\n\nOne study recruiting 225 apparently healthy adults met the inclusion criteria. This study took place in a high-income country. From 27,299 hits, the full texts of 193 papers were retrieved for examination against the inclusion criteria. However, there was only one paper that met the inclusion criteria. This study reported the effect of a PA intervention on cardio-respiratory fitness. There were no reported data for PA, quality of life, or cost effectiveness. The difference between the remote and web 2.0 versus face-to-face arms was not significant (SMD -0.02; 95% CI -0.30 to 0.26; high quality evidence). The risk of bias in the included study was assessed as low, and there was no evidence of an increased risk of adverse events.","Only one study met inclusion criteria.\nThere is insufficient evidence to assess whether face-to-face interventions or remote and web 2.0 approaches are more effective at promoting PA.\n"]
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[null,"Hollis, JL et al. Effectiveness of interventions using Motivational Interviewing for dietary and physical activity modification in adults: a systematic review, JBI Database of Systematic Reviews and Implementation Reports: May 2013 - Volume 11 - Issue 5 - p 1-27.\nAvailable here.","Participants aged 18 years or older.\n","This review aimed to synthesize the best available evidence on the effectiveness of dietary and physical activity interventions employing MI to achieve behavior change.\nOutcomes of interest included physical activity, including exercise or sedentary behaviors (energy expenditure, steps taken, minutes of physical activity or sitting time).\nNone of the six articles reporting on physical activity found any difference between MI and the attention control.\n\n","There is not yet sufficient evidence to conclude that MI enhances diet and physical activity behavior change above an attention control, although the findings from two studies are suggestive of a positive effect in decreasing dietary fat intake.\n\nImplications for practice \n\nWhen more high quality research evidence is available, the next challenge will be to establish evidence that research-based interventions will translate to the clinical setting.\n\nImplications for research \n\nMore high quality studies that objectively measure diet and physical activity, evaluate and report fidelity scores and compare a MI intervention to an attention control over a period of at least six months are required.\n"]

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[null,"GUIDANCE - SCHOOLS AND CHILDCARE SETTINGS"]
[null,"Source:","Audience:","Recommendations:"]
[null,"National Institute for Health and Care Excellence. Physical activity for children and young people. PH17. London: NICE; 2009 (updated 2020). \nAvailable here.","•Children’s trusts and services, early years providers, schools and college\n•Community and voluntary groups (running sports and other organised activities)\n•Government departments\n•Local authorities (leisure and related services, transport and planning, regeneration) and local strategic partnerships\n•Organisations offering practitioners education and training\n•The police\n•Primary care trusts\n•Private sector providers\n•Children, young people, their families and carers and members of the public\n\n\n","This guideline covers promoting physical activity for children and young people aged under 18 at home, preschool, school and in the community. It includes raising awareness of the benefits of physical activity, listening to what children and young people want, planning and providing spaces and facilities, and helping This guideline covers promoting physical activity for children and young people aged under 18 at home, preschool, school and in the community. It includes raising awareness of the benefits of physical activity, listening to what children and young people want, planning and providing spaces and facilities, and helping campaign and raising awareness about physical activity.\n\nThis guideline includes recommendations on:\n•Developing physical activity plans\n•Planning the provision of spaces and facilities\n•Responding to what children and young people want\n•Multi-component school and community programmes\n•Active and sustainable school travel plans\n•Helping children and families to be active\n"]
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[null,"National Institute for Health and Care Excellence. Physical activity: walking and cycling. PH41. London: NICE; 2012. \nAvailable here.","•Commissioners, managers and practitioners\n•Members of the public\n\n","This guideline covers encouraging people to increase the amount they walk or cycle for travel or recreation purposes.\n\nThis guideline includes recommendations on:\n•Policy and planning\n•Local programmes\n•Schools, workplaces and the NHS\n"]
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[null,"SYSTEMATIC REVIEWS - SCHOOLS AND CHILDCARE SETTINGS"]
[null,"Source:","Population:","Findings:","Authors' Conclusions:"]
[null,"Virgara  R, et al. Interventions in outside‐school hours childcare settings for promoting physical activity amongst schoolchildren aged 4 to 12 years. Cochrane Database of Systematic Reviews 2021, Issue 9. Art. No.: CD013380. DOI: 10.1002/14651858.CD013380.pub2.\nAvailable here","Children aged 4 to 12 years in outside‐school hours childcare settings.","This review sought to assess the effectiveness, cost-effectiveness and associated adverse events of interventions designed to increase physical activity in children aged 4 to 12 years in outside-school hours childcare settings.\nThere was low-certainty evidence that physical activity interventions may have little to no effect on total daily moderate-to-vigorous physical activity compared to no intervention (MD 1.7 minutes, 95% CI –0.42 to 3.82; P = 0.12; 6 trials; 3042 children). The authors were unable to pool data on proportion of the OSHC session spent in moderate-to-vigorous physical activity in a meta-analysis. Both trials showed an increase in proportion of session spent in moderate-to-vigorous physical activity (moderate-certainty evidence) from 4% to 7.3% of session time; however, only one trial was statistically significant. \nThere was low-certainty evidence that physical activity interventions may lead to little to no reduction in body mass index (BMI) as a measure of cardiovascular health, compared to no intervention (SMD –0.17, 95%CI –0.44 to 0.10; P = 0.22; 4 trials, 1684 children). \nPhysical activity interventions that were delivered online were more cost-effective than in person. Combined results suggest that staff-and-parent and staff-and-child-based interventions may lead to a small increase in overall daily physical activity and a small reduction or no difference in BMI. \nProcess evaluation was assessed differently by four of the included studies, with two studies reporting improvements in physical activity practices, one reporting high programme satisfaction and one high programme fidelity. The certainty of the evidence for these outcomes was low to moderate. Finally, there was very low-certainty evidence that physical activity interventions in outside-school hours childcare settings may increase cardiovascular fitness.\n","Although the review included nine trials, the evidence for how to increase children's physical activity in outside-school hours care settings remains limited, both in terms of certainty of evidence and magnitude of the effect. \nOf the types of interventions identified, when assessed using GRADE there was low-certainty evidence that multi-component interventions, with a specific physical activity goal may have as mall increase in daily moderate-to-vigorous physical activity and a slight reduction in BMI. \nThere was very low-certainty evidence that interventions increase cardiovascular fitness. By contrast there was moderate-certainty evidence that interventions were effective for increasing proportion of time spent in moderate-to-vigorous physical activity, and online training is cost-effective."]
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[null,"Neil-Sztramko  SE, Caldwell  H, Dobbins  M. School‐based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database of Systematic Reviews 2021, Issue 9. Art. No.: CD007651. DOI: 10.1002/14651858.CD007651.pub3.\nAvailable here\n","School-attending children and adolescents between the ages of 6 and 18 years.","Results show that school‐based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate‐certainty evidence) and may lead to little to no decrease in sedentary time (MD ‐3.78 minutes/d, 95% CI ‐7.80 to 0.24; 16 studies; low‐certainty evidence). \nSchool‐based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low‐certainty evidence). School‐based physical activity interventions may result in a very small decrease in BMI z‐scores (MD ‐0.06, 95% CI ‐0.09 to ‐0.02; 21 studies; low‐certainty evidence) and may not impact BMI expressed as kg/m² (MD ‐0.07, 95% CI ‐0.15 to 0.01; 50 studies; low‐certainty evidence).\n","Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school‐based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously."]
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[null,"Morgan  EH et al. Caregiver involvement in interventions for improving children's dietary intake and physical activity behaviours. Cochrane Database of Systematic Reviews 2020, Issue 1. Art. No.: CD012547. DOI: 10.1002/14651858.CD012547.pub2.\nAvailable here.\n","School-aged children and their caregivers","The aim of this Cochrane review was to assess effects of caregiver involvement in interventions for improving children's dietary intake and physical activity behaviours, including those intended to prevent overweight and obesity.\nMost studies were school-based and involved the addition of healthy eating or physical education classes, or both, sometimes in tandem with other changes to the school environment. \nThe behaviour change techniques used most commonly in the child-only arm were \"shaping knowledge,\" \"comparison of behaviour,\" \"feedback and monitoring,\" and \"repetition and substitution.\" In the child + caregiver arm, the strategies used most commonly included additional \"shaping knowledge\" or \"feedback and monitoring\" techniques, as well as \"social support\" and \"natural consequences.\"\nSix studies compared physical activity interventions with and without a caregiver component. \nAt the end of the intervention, the authors did not detect a difference between intervention arms in children's total physical activity (MD 0.20 min/h, 95% CI −1.19 to 1.59, 1 study, n = 54; low quality evidence) or moderate to vigorous physical activity (MVPA) (standard mean difference [SMD] 0.04, 95% CI −0.41 to 0.49, 2 studies, n = 80; moderate-quality evidence). No trial in this comparison reported data for percentage of children's total energy intake from saturated fat, sodium intake, fruit and vegetable intake, or SSB intake, nor for adverse effects of interventions.\n","Current evidence is insufficient to support the inclusion of caregiver involvement in interventions to improve children's dietary intake or physical activity behaviour, or both. For most outcomes, the quality of the evidence is adversely impacted by the small number of studies with available data, limited effective sample sizes, risk of bias, and imprecision. \nTo establish the value of caregiver involvement, additional studies measuring clinically important outcomes using valid and reliable measures, employing appropriate design and power, and following established reporting guidelines are needed, as is evidence on how such interventions might contribute to health equity."]
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[null,"Wolfenden  L et al. Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services. Cochrane Database of Systematic Reviews 2020, Issue 2. Art. No.: CD011779. DOI: 10.1002/14651858.CD011779.pub3.\nAvailable here.\n","Staff of centre-based childcare services.\n","The aim of this Cochrane review was to examine the effectiveness of strategies aimed at improving the implementation of policies, practices or programmes by childcare services that promote child healthy eating, physical activity and/or obesity prevention. \n\nFindings suggest that such interventions probably lead to little or no difference in child physical activity (four RCTs; moderate-certainty evidence) or weight status (three RCTs; moderate-certainty evidence).\n\nThe review findings suggest that implementation strategies probably improve the implementation of policies, practices or programmes that promote child healthy eating, physical activity and/or obesity prevention in childcare services. Of the 19 studies that compared a strategy to usual practice or minimal support control, 11 studies (nine RCTs) used score-based measures of implementation (e.g. childcare service nutrition environment score). Nine of these studies were included in pooled analysis, which found an improvement in implementation outcomes (SMD 0.49; 95% CI 0.19 to 0.79; participants = 495; moderate-certainty evidence). Ten studies (seven RCTs) used dichotomous measures of implementation (e.g. proportion of childcare services implementing a policy or specific practice), with seven of these included in pooled analysis (OR 1.83; 95% CI 0.81 to 4.11; participants = 391; low-certainty evidence).","Current research suggests that implementation strategies probably improve the implementation of policies, practices or programmes by childcare services, and may have little or no effect on measures of adverse effects. However such strategies appear to have little to no impact on measures of child diet, physical activity or weight status."]
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[null,"Langford  R et al. The WHO Health Promoting School framework for improving the health and well‐being of students and their academic achievement. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD008958. DOI: 10.1002/14651858.CD008958.pub2.\nAvailable here.\n","Children and young people aged four to 18 years, attending schools or colleges.\n","The aim of this Cochrane review was to assess the effectiveness of the Health Promoting Schools (HPS) framework in improving the health and well-being of students and their academic achievement.\nIn this review, the authors define HPS interventions as comprising the following three elements: input to the curriculum; changes to the school’s ethos or environment or both; and engagement with families or communities, or both. The authors  compared this intervention against schools that implemented either no intervention or continued with their usual practice, or any programme that included just one or two of the above mentioned HPS elements.\nThe authors found positive effects for some interventions for: body mass index (BMI), physical activity and physical fitness. Two studies (Kriemler 2010 and Simon 2006) compared physical activity only with a control, and found a small increase in physical activity levels (SMD 0.17, 95% CI: 0.16-0.5).\nIntervention effects were generally small but have the potential to produce public health benefits at the population level.\n","The results of this review provide evidence for the effectiveness of some interventions based on the HPS framework for improving certain health outcomes but not others. More well-designed research is required to establish the effectiveness of this approach for other health topics and academic achievement."]

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[null,"GUIDANCE - WORKPLACE"]
[null,"Source:","Audience:","Recommendations:"]
[null,"National Institute for Health and Care Excellence. Physical activity and the environment. NG90. London: NICE; 2018. \nAvailable here.\n\nUnderpinning evidence reviews:\n\nEvidence review 1 here.\n\nEvidence review 2 here.\n\nEvidence review 3 here.\n\n\n\n","•Local authorities and metro mayors, including agencies contracted to deliver environmental changes for local authorities\n•Others responsible for open spaces used by the public such as in workplaces, community-owned gardens and playing fields\n•Housing, local enterprise partnerships and others responsible for the built environment\n•Public transport planners and providers\n•Organisations working to ensure people with limited mobility can be physically active\n\nIt may also be relevant for members of the public\n\n","This guideline covers how to improve the physical environment to encourage and support physical activity. The aim is to increase the general population’s physical activity levels.\n\nThis guideline includes recommendations on:\n•Strategies, policies and plans to increase physical activity in the local environment\n•Active travel\n•Public open spaces\n•Buildings\n•Schools\n"]
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[null,"National Institute for Health and Care Excellence. Behaviour change: individual approaches. PH49. London: NICE; 2014. \nAvailable here.","•Healthcare professionals\n•Commissioners and providers\n•Young people and adults, and their families and carers\n\n","This guideline covers changing health-damaging behaviours among people aged 16 and over using interventions such as goals and planning, feedback and monitoring, and social support. It aims to help tackle a range of behaviours including alcohol misuse, poor eating patterns, lack of physical activity, unsafe sexual behaviour and smoking.\n\nThis guideline includes recommendations on:\n•developing local behaviour change policy and strategy\n•commissioning interventions\n•planning interventions that take account of local needs\n•ensuring interventions meet individual needs\n•delivering interventions\n•commissioning and providing training\n•monitoring and evaluating interventions\n"]
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[null,"National Institute for Health and Care Excellence. Physical activity: walking and cycling. PH41. London: NICE; 2012. \nAvailable here.","•Commissioners, managers and practitioners\n•Members of the public\n\n","This guideline covers encouraging people to increase the amount they walk or cycle for travel or recreation purposes.\n\nThis guideline includes recommendations on:\n•policy and planning\n•local programmes\n•schools, workplaces and the NHS\n"]
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[null,"SYSTEMATIC REVIEWS - WORKPLACE"]
[null,"Source:","Population:","Findings:","Authors' Conclusions:"]
[null,"Freak-Poli  RLA et al. Workplace pedometer interventions for increasing physical activity. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No.: CD009209. DOI: 10.1002/14651858.CD009209.pub3.\nAvailable here.\n","Both healthy populations and those at risk of chronic disease (e.g. through inactivity or overweight), with a mean age of 41 years","This Cochrane review sought to assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving long-term health outcomes.\n\nWhen pedometer interventions are compared to minimal interventions at follow-up points at least one month after completion of their intervention, pedometers may have no effect on physical activity (6 studies; very low-certainty evidence; no meta-analysis due to very high heterogeneity), but the effect is very uncertain. \n\nPedometers may have effects on sedentary behaviour and on quality of life (mental health component), but these effects were very uncertain (1 study; very low-certainty evidence).\n\nPedometer interventions may slightly reduce anthropometry (body mass index (BMI) -0.64, 95% confidence interval (CI) -1.45 to 0.18; 3studies; low-certainty evidence). \n\nPedometer interventions probably had little to no effect on blood pressure (systolic: -0.08 mmHg, 95%CI -3.26 to 3.11; 2 studies; moderate-certainty evidence) and may have reduced adverse effects (such as injuries; from 24 to 10 per 100 people in populations experiencing relatively frequent events; odds ratio (OR) 0.50, 95% CI 0.30 to 0.84; low-certainty evidence). \n\nNo studies compared biochemical measures or disease risk scores at follow-up after completion of the intervention versus a minimal intervention. \n\nComparison of pedometer interventions to alternative physical activity interventions at follow-up points at least one month after completion of the intervention revealed that pedometers may have an effect on physical activity, but the effect is very uncertain (1 study; very low-certainty evidence). \n\nSedentary behaviour, anthropometry (BMI or waist circumference), blood pressure (systolic or diastolic),biochemistry (low-density lipoprotein (LDL) cholesterol, total cholesterol, or triglycerides), disease risk scores, quality of life (mental or physical health components), and adverse effects at follow-up after completion of the intervention were not compared to an alternative physical activity intervention.\n\nSome positive effects were observed immediately at completion of the intervention periods, but these effects were not consistent, and overall certainty of evidence was insufficient to assess the effectiveness of workplace pedometer interventions\n ","Interventions can have positive effects on employee physical activity and health, although current evidence is insufficient to suggest that a pedometer-based intervention would be more effective than other options. \nIt is important to note that over the past decade, technological advancement in accelerometers as commercial products, often freely available in Smartphones, has in many ways rendered the use of pedometers outdated. Future studies aiming to test the impact of either pedometers or accelerometers would likely find any control arm highly contaminated. \nDecision-makers considering allocating resources to large-scale programmes of this kind should be cautious about the expected benefits of incorporating a pedometer and should note that these effects may not be sustained over the longer term. \nFuture studies should be designed to identify the effective components of multi-component interventions, although pedometers may not be given the highest priority (especially considering the increased availability of accelerometers). Approaches to increase the sustainability of intervention effects and behaviours over a longer term should be considered, as should more consistent measures of physical activity and health outcomes"]
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[null,"Wolfenden  L et al. Strategies to improve the implementation of workplace‐based policies or practices targeting tobacco, alcohol, diet, physical activity and obesity. Cochrane Database of Systematic Reviews 2018, Issue 11. Art. No.: CD012439. DOI: 10.1002/14651858.CD012439.pub2.\nAvailable here.\n","Any workplace setting staffed by paid employees. ","This Cochrane review aimed to assess the effects of strategies for improving the implementation of workplace-based policies or practices targeting diet, physical activity, obesity, tobacco use and alcohol use, and to assess the impact of such strategies on employee health behaviours.\nThe authors included six trials, four of which took place in the USA.\nAll implementation interventions utilised multiple implementation strategies, the most common of which were educational meetings, tailored interventions and local consensus processes.\nThree trials examined the impact of implementation strategies on employee health behaviours, reporting mixed effects for diet and weight status (very low certainty evidence) and no effect for physical activity (very low certainty evidence) or tobacco use (low certainty evidence).","Available evidence regarding the effectiveness of implementation strategies for improving implementation of health-promoting policies and practices in the workplace setting is sparse and inconsistent. Low certainty evidence suggests that such strategies may make little or no difference on measures of implementation fidelity or different employee health behaviour outcomes. It is also unclear if such strategies are cost-effective or have potential unintended adverse consequences. The limited number of trials identified suggests implementation research in the workplace setting is in its infancy, warranting further research to guide evidence translation in this setting."]
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[null,"Shrestha  N et al. Workplace interventions for reducing sitting at work. Cochrane Database of Systematic Reviews 2018, Issue 12. Art. No.: CD010912. DOI: 10.1002/14651858.CD010912.pub5.\nAvailable here.\n","Employees who sit at work","This Cochrane review aimed to evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions.\nThe included studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi‐component interventions (four studies). One study included both physical workplace changes and information and counselling components.\n\nPhysical workplace changes \n\nInterventions using sit‐stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short‐term follow‐up (up to three months) compared to sit‐desks (95% confidence interval (CI) −116 to −84, 10 studies, low‐quality evidence).\n\nWorkplace policy changes \n\nThe authors found no significant effects for implementing walking strategies on workplace sitting time at short‐term (MD −15 minutes per day, 95% CI −50 to 19, low‐quality evidence, one study) and medium‐term (MD −17 minutes/day, 95% CI −61 to 28, one study) follow‐up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI −66 to −15, one study, low‐quality evidence) compared to long breaks (two 15‐minute breaks per workday) at short‐term follow‐up.\n\nInformation and counselling \n\nProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short‐term follow‐up (MD −19 minutes per day, 95% CI −57 to 19, two studies, low‐quality evidence). However, the reduction was significant at medium‐term follow‐up (MD −28 minutes per day, 95% CI −51 to −5, two studies, low‐quality evidence).\n\nMulti‐component interventions \n\nCombining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low‐quality evidence) and on time spent in prolonged sitting bouts (two studies, very low‐quality evidence) at short‐term follow‐up.","At present there is low‐quality evidence that the use of sit‐stand desks reduce workplace sitting at short‐term and medium‐term follow‐ups. However, there is no evidence on their effects on sitting over longer follow‐up periods. \n\nEffects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi‐component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. \n\nThere is a need for larger cluster‐RCTs with longer‐term follow‐ups to determine the effectiveness of different types of interventions to reduce sitting time at work."]

{"sheet":"Environment","index":8,"n_rows":81,"n_cols":5,"rows_kept":81,"cut":false,"hidden":false,"merged":[[20,1,20,4],[22,1,46,1],[22,2,46,2],[22,3,46,4],[80,1,95,1],[78,1,78,4],[80,2,95,2],[80,3,95,3],[80,4,95,4],[47,1,68,1],[47,3,68,4],[70,1,76,1],[70,2,76,2],[70,3,76,4],[69,3,69,4],[47,2,68,2]]}
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[null,"GUIDANCE - ENVIRONMENT"]
[null,"Source:","Audience:","Recommendations:"]
[null,"National Institute for Health and Care Excellence. Physical activity for children and young people. PH17. London: NICE; 2009 (updated 2020). \nAvailable here.\n","•Children’s trusts and services, early years providers, schools and college\n•Community and voluntary groups (running sports and other organised activities)\n•Government departments\n•Local authorities (leisure and related services, transport and planning, regeneration) and local strategic partnerships\n•Organisations offering practitioners education and training\n•The police\n•Primary care trusts\n•Private sector providers\n•Children, young people, their families and carers and members of the public\n\n","This guideline covers promoting physical activity for children and young people aged under 18 at home, preschool, school and in the community. It includes raising awareness of the benefits of physical activity, listening to what children and young people want, planning and providing spaces and facilities, and helping families build physical activity into their daily lives.\n\nThis guideline includes recommendations on:\n•Delivering a national campaign and raising awareness about physical activity\n•Developing physical activity plans\n•Planning the provision of spaces and facilities\n•Responding to what children and young people want\n•Multi-component school and community programmes\n•Active and sustainable school travel plans\n•Helping children and families to be active"]
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[null,"National Institute for Health and Care Excellence. Physical activity and the environment. NG90. London: NICE; 2018. \nAvailable here.\n\nUnderpinning evidence reviews:\n\nEvidence Review 1 here.\n\nEvidence Review 2 here.\n\nEvidence Review 3 here.\n\n\n\n\n","•Local authorities and metro mayors, including agencies contracted to deliver environmental changes for local authorities\n•Others responsible for open spaces used by the public such as in workplaces, community-owned gardens and playing fields\n•Housing, local enterprise partnerships and others responsible for the built environment\n•Public transport planners and providers\n•Organisations working to ensure people with limited mobility can be physically active\n\nIt may also be relevant for members of the public.","This guideline covers how to improve the physical environment to encourage and support physical activity. The aim is to increase the general population’s physical activity levels.\n\nThis guideline includes recommendations on:\n•Strategies, policies and plans to increase physical activity in the local environment\n•Active travel\n•Public open spaces\n•Buildings\n•Schools"]
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[null,"National Institute for Health and Care Excellence. Physical activity: walking and cycling. PH41. London: NICE; 2012. \nAvailable here.","•Commissioners, managers and practitioners\n•Members of the public\n","This guideline covers encouraging people to increase the amount they walk or cycle for travel or recreation purposes.\n\nThis guideline includes recommendations on:\n•Policy and planning\n•Local programmes\n•Schools, workplaces and the NHS"]
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[null,"SYSTEMATIC REVIEWS - ENVIRONMENT"]
[null,"Source:","Population:","Findings:","Authors' Conclusions:"]
[null,"Husk  K, et al. Participation in environmental enhancement and conservation activities for health and well‐being in adults: a review of quantitative and qualitative evidence. Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No.: CD010351. DOI: 10.1002/14651858.CD010351.pub2.\nAvailable here.","Adults (aged ≥ 18 years).","This Cochrane review sought to assess the health and well‐being impacts on adults following participation in environmental enhancement and conservation activities.\nThere was limited evidence that participation had positive effects on self-reported health, quality of life and physical activity levels. Some also reported increased mental fatigue and greater feelings of anxiety.","There is little quantitative evidence of positive or negative health and well‐being benefits from participating in EECA. However, the qualitative research showed high levels of perceived benefit among participants. \nQuantitative evidence resulted from study designs with high risk of bias, qualitative evidence lacked reporting detail. The majority of included studies were programme evaluations, conducted internally or funded by the provider."]

{"sheet":"Community","index":9,"n_rows":163,"n_cols":5,"rows_kept":163,"cut":false,"hidden":false,"merged":[[109,1,130,1],[109,2,130,2],[109,3,130,3],[109,4,130,4],[20,1,20,4],[107,1,107,4],[22,1,44,1],[22,2,44,2],[22,3,44,4],[59,1,73,1],[59,2,73,2],[59,3,73,4],[45,1,58,1],[45,2,58,2],[45,3,58,4],[88,1,105,1],[88,2,105,2],[88,3,105,4],[74,1,87,1],[74,2,87,2],[74,3,87,4],[162,3,180,3],[162,4,180,4],[162,2,180,2],[162,1,180,1],[131,1,149,1],[131,2,149,2],[131,3,149,3],[131,4,149,4],[150,1,161,1],[150,2,161,2],[150,3,161,3],[150,4,161,4]]}
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[null,"GUIDANCE - COMMUNITY"]
[null,"Source:","Audience:","Recommendations:"]
[null,"National Institute for Health and Care Excellence. Physical activity and the environment. NG90. London: NICE; 2018. \nAvailable here.\n\nUnderpinning evidence reviews:\n\nEvidence Review 1 here.\n\nEvidence Review 2 here.\n\nEvidence Review 3 here.\n\n\n","•Local authorities and metro mayors, including agencies contracted to deliver environmental changes for local authorities\n•Others responsible for open spaces used by the public such as in workplaces, community-owned gardens and playing fields\n•Housing, local enterprise partnerships and others responsible for the built environment\n•Public transport planners and providers\n•Organisations working to ensure people with limited mobility can be physically active\n\nIt may also be relevant for members of the public\n","This guideline covers how to improve the physical environment to encourage and support physical activity. The aim is to increase the general population’s physical activity levels.\n\nThis guideline includes recommendations on:\n•Strategies, policies and plans to increase physical activity in the local environment\n•Active travel\n•Public open spaces\n•Buildings\n•Schools\n"]
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[null,"National Institute for Health and Care Excellence. Community pharmacies: promoting health and wellbeing. NG102. London: NICE; 2018. \nAvailable here.","•Community pharmacies, local pharmaceutical committees and pharmacy organisations\n•Commissioners of health-promoting interventions including local authorities, clinical commissioning groups and NHS England\n•Local professional networks (hosted by NHS England)\n•Health and wellbeing boards\n\n","This guideline covers how community pharmacies can help maintain and improve people’s physical and mental health and wellbeing, including people with a long-term condition. It aims to encourage more people to use community pharmacies by integrating them within existing health and care pathways and ensuring they offer standard services and a consistent approach. It requires a collaborative approach from individual pharmacies and their representatives, local authorities and other commissioners\n\nThis guideline includes recommendations on:\n•Health and wellbeing hub\n•Overarching principles of good practice\n•Awareness raising and providing information\n•Advice and education\n•Behavioural support\n•Referrals and signposting\n"]
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[null,"National Institute for Health and Care Excellence. Behaviour change: general approaches. PH6. London: NICE; 2017. \nLast updated: 2017\nAvailable here.\n\nUnderpinning evidence review here.\n\n\n","•National policy makers, commissioners, providers and practitioners in the NHS, local authorities and the community and voluntary sectors\n•Researchers, including those who oversee research funding\n•Social and behavioural scientists\n•Health economists working on health-related knowledge, attitude and behaviour change\n ","This guideline covers a set of principles that can be used to help people change their behaviour. The aim is for practitioners to use these principles to encourage people to adopt a healthier lifestyle by, for example, stopping smoking, adopting a healthy diet and being more physically active.\n\nThis guideline recommends a set of principles to use as the basis for:\n•Providing education and training for those delivering them\n•Delivery of these activities, including one-to-one and community-based programmes and those aimed at specific populations\n•Evaluation of their effectiveness and cost effectiveness\n"]
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[null,"National Institute for Health and Care Excellence. Physical activity: exercise referral schemes. PH54. London: NICE; 2014. \nAvailable here.\n\nUnderpinning evidence review here.\n\n\n","•Policy makers and commissioners in local authorities and the NHS\n•Primary care practitioners and other practitioners with physical activity as part of their remit\n•Providers of exercise referral schemes\n•Organisations that provide exercise qualifications and accreditation\n•Members of the public\n\n","This guideline covers exercise referral schemes for people aged 19 and older, in particular, those who are inactive or sedentary. The aim is to encourage people to be physically active.\n\nThis guideline includes recommendations on:\n•Exercise referral for people who are sedentary or inactive but otherwise healthy\n•Exercise referral for people who are sedentary or inactive and have a health condition or other health risk factors"]
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[null,"National Institute for Health and Care Excellence. Mental wellbeing in over 65s: occupational therapy and physical activity interventions. PH16. London: NICE; 2008.\nAvailable here.\n\n\nNOTE: Recommendation 2 was updated 2020 and has been included; other recommendations and the guidance as a whole are older than 10 years.","Older people and their carers.","This guideline covers promoting mental wellbeing in people aged over 65. It focuses on practical support for everyday activities, based on occupational therapy principles and methods. This includes working with older people and their carers to agree what kind of support they need.\n\nRecommendation 2 is aimed at\nphysiotherapists, registered exercise professionals and fitness instructors and other health, social care, leisure services and voluntary sector staff who have the qualifications, skills and experience to deliver exercise programmes appropriate for older people.\n\n\nRecommendation 2 suggests:\nin collaboration with older people and their carers, offer tailored exercise and physical activity programmes in the community.\n"]
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[null,"SYSTEMATIC REVIEWS - COMMUNITY"]
[null,"Source:","Population:","Findings:","Authors' Conclusions:"]
[null,"Baker PRA et al. Community wide interventions for increasing physical activity. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No.: CD008366. DOI: 10.1002/14651858.CD008366.pub3.\nAvailable here.","Persons of any age residing in a geographically defined community, such as urban, peri-urban, village, town, or city.\n","The aim of this Cochrane review was to evaluate the effects of community wide, multi-strategic interventions upon population levels of physical activity.\n\nOne study obtained objective population representative measurements of physical activity by accelerometers, while the remaining three low-risk studies used validated self-reported measures. The study using accelerometry, conducted in low income, high crime communities of USA, emphasised social marketing, partnership with police and environmental improvements. No change in the seven-day average daily minutes of moderate to vigorous physical activity was observed during the two years of operation. Some program level effect was observed with more people walking in the intervention community, however this result was not evident in the whole community. Similarly, the two studies conducted in the United Kingdom (one in rural villages and the other in urban London; both using communication, partnership and environmental strategies) found no improvement in the mean levels of energy expenditure per person per week, measured from one to four years from baseline. \nNone of the three low risk studies reporting a dichotomous outcome of physical activity found improvements associated with the intervention. Overall, there was a noticeable absence of reporting of benefit in physical activity for community wide interventions in the included studies. However, as a group, the interventions undertaken in China appeared to have the greatest possibility of success with high participation rates reported. \nReporting bias was evident with two studies failing to report physical activity measured at follow up. No adverse events were reported. The data pertaining to cost and sustainability of the interventions were limited and varied.","Although numerous studies have been undertaken, there is a noticeable inconsistency of the findings in the available studies and this is confounded by serious methodological issues within the included studies. \nThe body of evidence in this review does not support the hypothesis that the multi-component community wide interventions studied effectively increased physical activity for the population, although some studies with environmental components observed more people walking."]
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[null,"Richards  J et al. Face‐to‐face interventions for promoting physical activity. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD010392. DOI: 10.1002/14651858.CD010392.pub2.\nAvailable here.\n","Community dwelling adults (aged 16 years and above)","The aim of this Cochrane review was to compare the effectiveness of face-to-face interventions for PA promotion in community dwelling adults (aged 16 years and above) with a control exposed to placebo or no or minimal intervention.\n\nThe effect of interventions on self-reported PA at one year (eight studies; 6725 participants) was positive and moderate with significant heterogeneity (I= 74%) (SMD 0.19; 95% CI 0.06 to 0.31; moderate quality evidence) but not sustained in three studies at 24 months (4235 participants) (SMD 0.18; 95% CI -0.10 to 0.46). \nThe effect of interventions on cardiovascular fitness at one year (two studies; 349 participants) was positive and moderate with no significant heterogeneity in the observed effects (SMD 0.50; 95% CI 0.28 to 0.71; moderate quality evidence). \nThree studies (3277 participants) reported a positive effect on increasing PA levels when assessed as a dichotomous measure at 12 months, but this was not statistically significant (OR 1.52; 95% CI 0.88 to 2.61; high quality evidence). \n\nAny conclusions drawn from this review require some caution given the significant heterogeneity in the observed effects. Despite this, there was some indication that the most effective interventions were those that offered both individual and group support for changing PA levels using a tailored approach. The long-term impact, cost effectiveness and rates of adverse events for these interventions was not established because the majority of studies stopped after 12 months.","Although the authors found evidence to support the effectiveness of face-to-face interventions for promoting PA, at least at 12 months, the effectiveness of these interventions was not supported by high quality studies. \nDue to the clinical and statistical heterogeneity of the studies, only limited conclusions can be drawn about the effectiveness of individual components of the interventions. \n\nFuture studies should provide greater detail of the components of interventions, and assess impact on quality of life, adverse events and economic data."]
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[null,"Richards  J et al. Face‐to‐face versus remote and web 2.0 interventions for promoting physical activity. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD010393. DOI: 10.1002/14651858.CD010393.pub2.\nAvailable here.\n","Community dwelling adults (aged 16 years and above).","The aim of this Cochrane review was to compare the effectiveness of face-to-face versus remote and web 2.0 interventions for PA promotion in community dwelling adults (aged 16 years and above).\n\nOne study recruiting 225 apparently healthy adults met the inclusion criteria. This study took place in a high-income country. From 27,299 hits, the full texts of 193 papers were retrieved for examination against the inclusion criteria. However, there was only one paper that met the inclusion criteria. This study reported the effect of a PA intervention on cardio-respiratory fitness. There were no reported data for PA, quality of life, or cost effectiveness. The difference between the remote and web 2.0 versus face-to-face arms was not significant (SMD -0.02; 95% CI -0.30 to 0.26; high quality evidence). The risk of bias in the included study was assessed as low, and there was no evidence of an increased risk of adverse events.","Only one study met inclusion criteria.\nThere is insufficient evidence to assess whether face-to-face interventions or remote and web 2.0 approaches are more effective at promoting PA.\n"]
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[null,"Collins, CE et al. Effectiveness of parent-centred interventions for the prevention and treatment of childhood overweight and obesity in community settings: a systematic review, JBI Database of Systematic Reviews and Implementation Reports: September 2013 - Volume 11 - Issue 9 - p 180-257 doi: 10.11124/jbisrir-2013-709\nAvailable here.","Children of pre-school, primary and\nsecondary school age and/or their parents/guardians aged >18 years.\n","The objective of this review was to identify the effectiveness of parent-centred interventions\nimplemented in the community setting in modifying eating and physical activity behaviours or weight related\noutcomes of children. \n\nNineteen studies reported a physical activity or sedentary behaviour measure. The outcome measures for physical activity were more varied than for diet, with 11 different measures across the studies, including: steps per day, time spent in activity, and energy expenditure. The most common measure was the total amount of daily physical activity, commonly measured as time spent in moderate/vigorous activity (n=8 studies), total step counts/day assessed in two studies and total daily screen time measured in six studies. Two studies reported increases in the number of daily steps at 10 weeks in one study and six months in another, while two studies reported changes in screen time ranging from -1.8 hours per day to -17.5 hours per week. The majority of studies objectively measured physical activity through use of accelerometers (seven studies) all described as being worn for at least three days.\n","Results from the review support the after-school setting as the most promising for community\nintervention setting for targeting parents as agents of change within child obesity prevention and\ntreatment programs.\n\nImplications for practice:\n\nAt this stage, interventions to support parents should target the after-school environment as opposed\nto being conducted in the home, summer camps, leisure centres or churches. Targeting a decrease\nin energy intake and sweetened beverages in parallel with increasing number of daily steps and\ndecreasing screen time use."]

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[null,"GUIDANCE - NHS SERVICES"]
[null,"Source:","Audience:","Recommendations:"]
[null,"National Institute for Health and Care Excellence. Community pharmacies: promoting health and wellbeing. NG102. London: NICE; 2018. \nAvailable here.\n","•Community pharmacies, local pharmaceutical committees and pharmacy organisations\n•Commissioners of health-promoting interventions including local authorities, clinical commissioning groups and NHS England\n•Local professional networks (hosted by NHS England)\n•Health and wellbeing boards\n","This guideline covers how community pharmacies can help maintain and improve people’s physical and mental health and wellbeing, including people with a long-term condition. It aims to encourage more people to use community pharmacies by integrating them within existing health and care pathways and ensuring they offer standard services and a consistent approach. It requires a collaborative approach from individual pharmacies and their representatives, local authorities and other commissioners.\n\nThis guideline includes recommendations on:\n•Health and wellbeing hub\n•Overarching principles of good practice\n•Awareness raising and providing information\n•Advice and education\n•Behavioural support\n•Referrals and signposting"]
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[null,"National Institute for Health and Care Excellence. Physical activity: brief advice for adults in primary care. PH44. London: NICE; 2013.\nAvailable here.\n\nUnderpinning evidence review here.\n\n\n","•Commissioners and practitioners\n•Members of the public","This guideline covers providing brief advice on physical activity to adults in primary care. It aims to improve health and wellbeing by raising awareness of the importance of physical activity and encouraging people to increase or maintain their activity level.\n\nThis guideline includes recommendations on:\n•Identifying adults who are inactive\n•Delivering and following up on brief advice\n•Incorporating brief advice in commissioning\n•Systems to support brief advice\n•Providing information and training"]
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[null,"National Institute for Health and Care Excellence. Physical activity: walking and cycling. PH41. London: NICE; 2012. \nAvailable here.","•Commissioners, managers and practitioners\n•Members of the public","This guideline covers encouraging people to increase the amount they walk or cycle for travel or recreation purposes.\n\nThis guideline includes recommendations on:\n•Policy and planning\n•Local programmes\n•Schools, workplaces and the NHS\n"]
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[null,"SYSTEMATIC REVIEWS - NHS SERVICES"]
[null,"Source:","Population:","Findings:","Authors' Conclusions:"]
[null,null,null,"No systematic reviews found."]

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[null,"*ARIAL 16, ALL CAPS*"]
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[null,"GUIDANCE: *VERDANA 10. ALL CAPS*"]
[null,"Source:","Audience:","Recommendations:"]
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[null,"SYSTEMATIC REVIEWS: *VERDANA 10. ALL CAPS*"]
[null,"Source:","Population:","Findings:","Authors' Conclusions:"]
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[null,null,null,"*Hide lines below this section and delete this sentence*"]

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[null,"*ARIAL 16, ALL CAPS*"]
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[null,"GUIDANCE: *VERDANA 10. ALL CAPS*"]
[null,"Source:","Audience:","Recommendations:"]
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[null,"SYSTEMATIC REVIEWS: *VERDANA 10. ALL CAPS*"]
[null,"Source:","Population:","Findings:","Authors' Conclusions:"]
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[null,null,null,"*Hide lines below this section and delete this sentence*"]

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[null,"*ARIAL 16, ALL CAPS*"]
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[null,"GUIDANCE: *VERDANA 10. ALL CAPS*"]
[null,"Source:","Audience:","Recommendations:"]
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[null,"SYSTEMATIC REVIEWS: *VERDANA 10. ALL CAPS*"]
[null,"Source:","Population:","Findings:","Authors' Conclusions:"]
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[null,null,null,"*Hide lines below this section and delete this sentence*"]

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[null,"ABBREVIATIONS WITH FULL FORMS"]
[null,"ABBREVIATION","FULL FORM"]
[null,"BMI","Body mass index"]
[null,"CI","Confidence interval"]
[null,"EECA","Environmental enhancement and conservation activities"]
[null,"ERS","Exercise referral scheme"]
[null,"HPS","Health promoting schools"]
[null,"ITT","Intention to treat"]
[null,"MD","Medical doctor"]
[null,"MVPA","Moderate to vigourous physical activity"]
[null,"NCD","Non communicable disease"]
[null,"NHS","National Health Service"]
[null,"PA","Physical activity"]
[null,"RCT","Randomised controlled trial"]
[null,"SMD","Standardised Mean Difference"]