The Olympic legacy for health
The London 2012 Olympic Games were back in the news this week, with government economists reporting a £9.9 billion boost to UK trade and investment from hosting the Games.1
Regardless of the purported economic benefits, it seems the much anticipated Olympic legacy for health has yet to be established. The House of Commons Education Select Committee has said that the Government needs to devise a longer-term strategy to build on Olympic enthusiasm or risk its existing plans becoming “little more than a gimmick”.2
Early results from the 2012 Health Survey for England found that levels of physical activity among adults barely changed last year when compared to four years earlier, with “no Olympic legacy yet visible”. Just 59% of surveyed adults hit the Government target of at least 150 minutes of moderate exercise or 75 minutes of vigorous activity per week.3 These data were collected over the whole of 2012, so it may be some time before the true impact of the Games – if any – become apparent.
The reality is that the Olympics Games is a vast one-off event that takes place in a different country once every four years and is watched by people all across the globe; teasing out its true impact on regional health behaviours and outcomes is probably impossible. Most of the useful research on increasing physical activity and participation in sport has therefore focused on smaller scale interventions, many of these targeted at children and young people.4-23
Over 200 systematic reviews on DARE evaluate interventions related to sporting or physical activity. Some of these systematic reviews have been cautiously optimistic about the effectiveness of physical activity promotion based in primary care24 and other settings,25 others have been less convinced about the value of mass media campaigns beyond raising awareness,26,27 while the evidence for multi-strategic community wide interventions is decidedly mixed.28
A wide-ranging cost-effectiveness analysis of physical activity interventions generally found less intensive methods to be more cost-effective and concluded that most of those examined provided good value for money.29References
1. London 2012 Olympics 'have boosted UK economy by £9.9bn' http://www.bbc.co.uk/news/uk-23370270
2. Report on school sport following London 2012: no more political football http://www.parliament.uk/business/committees/committees-a-z/commons-select/education-committee/news/school-sports-substantive/
3. Health Survey for England - 2012, Early results http://www.hscic.gov.uk/catalogue/PUB11218
4. Atkin AJ, Gorely T, Biddle SJ, Cavill N, Foster C. Interventions to promote physical activity in young people conducted in the hours immediately after school: a systematic review. International Journal of Behavioral Medicine. 2011;18(3):176-87. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12011006055
5. Biddle SJ, O'Connell S, Braithwaite RE. Sedentary behaviour interventions in young people: a meta-analysis. British Journal of Sports Medicine. 2011;45(11):937-42. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12011006539
6. Camacho-Minano MJ, LaVoi NM, Barr-Anderson DJ. Interventions to promote physical activity among young and adolescent girls: a systematic review. Health Education Research. 2011;26(6):1025-49. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12012001664
7. Chillon P, Evenson KR, Vaughn A, Ward DS. A systematic review of interventions for promoting active transportation to school. International Journal of Behavioral Nutrition and Physical Activity. 2011;8(10). http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12011005541
8. De Bourdeaudhuij I, Van Cauwenberghe E, Spittaels H, Oppert JM, Rostami C, Brug J, et al. School-based interventions promoting both physical activity and healthy eating in Europe: a systematic review within the HOPE project. Obesity Reviews. 2011;12(3):205-16. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12011001933
9. Demetriou Y, Honer O. Physical activity interventions in the school setting: a systematic review. Psychology of Sport and Exercise. 2012;13(2):186-96. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12012011150
10. Dobbins M, DeCorby K, Robeson P, Husson H, Tirilis D. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18. Cochrane Database of Systematic Reviews: Reviews. 2009;Issue 1. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=10000007651
11. Dobbins M, Lockett D, Michel I, Beyers J, Feldman L, Vohra J, et al. The effectiveness of school-based interventions in promoting physical activity and fitness among children and youth: a systematic review. Hamilton, ON: Effective Public Health Practice Project (EPHPP). Retrieved from: http://old.hamilton.ca/phcs/ephpp/Research/Full-Reviews/Physical-Activity-Review.pdf. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12002008009
12. Dudley D, Okely A, Pearson P, Cotton W. A systematic review of the effectiveness of physical education and school sport interventions targeting physical activity, movement skills and enjoyment of physical activity. European Physical Education Review. 2011;17(3):353-78. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12012053806
13. Hieftje K, Edelman EJ, Camenga DR, Fiellin LE. Electronic media-based health interventions promoting behavior change in youth: a systematic review. JAMA Pediatrics. 2013;167(6):574-80. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12013020552
14. Hodges EA, Smith C, Tidwell S, Berry D. Promoting physical activity in preschoolers to prevent obesity: a review of the literature. Journal of Pediatric Nursing. 2013;28(1):3-19. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12013013296
15. Lonsdale C, Rosenkranz RR, Peralta LR, Bennie A, Fahey P, Lubans DR. A systematic review and meta-analysis of interventions designed to increase moderate-to-vigorous physical activity in school physical education lessons. Preventive Medicine. 2013;56(2):152-61. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12013008495
16. Metcalf B, Henley W, Wilkin T. Effectiveness of intervention on physical activity of children: systematic review and meta-analysis of controlled trials with objectively measured outcomes (EarlyBird 54). BMJ. 2012;345:e5888. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12012043230
17. Nixon CA, Moore HJ, Douthwaite W, Gibson EL, Vogele C, Kreichauf S, et al. Identifying effective behavioural models and behaviour change strategies underpinning preschool- and school-based obesity prevention interventions aimed at 4-6-year-olds: a systematic review. Obesity Reviews. 2012;13(Supplement 1):106-17. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12012009927
18. Parrish AM, Okely AD, Stanley RM, Ridgers ND. The effect of school recess interventions on physical activity: a systematic review. Sports Medicine. 2013;43(4):287-99. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12013021958
19. Robertson-Wilson JE, Dargavel MD, Bryden PJ, Giles-Corti B. Physical activity policies and legislation in schools: a systematic review. American Journal of Preventive Medicine. 2012;43(6):643-9. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12012056233
20. Slingerland M, Borghouts L. Direct and indirect influence of physical education-based interventions on physical activity: a review. Journal of Physical Activity and Health. 2011;8(6):866-78. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12012001017
21. Sun C, Pezic A, Tikellis G, Ponsonby AL, Wake M, Carlin JB, et al. Effects of school-based interventions for direct delivery of physical activity on fitness and cardiometabolic markers in children and adolescents: a systematic review of randomized controlled trial. Obesity Reviews. 2013:epub. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12013030922
22. van Grieken A, Ezendam NP, Paulis WD, van der Wouden JC, Raat H. Primary prevention of overweight in children and adolescents: a meta-analysis of the effectiveness of interventions aiming to decrease sedentary behaviour. International Journal of Behavioral Nutrition and Physical Activity. 2012;9:61. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12012046898
23. Van Lippevelde W, Verloigne M, De Bourdeaudhuij I, Brug J, Bjelland M, Lien N, et al. Does parental involvement make a difference in school-based nutrition and physical activity interventions? A systematic review of randomized controlled trials. International Journal of Public Health. 2012;57(4):673-8. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12012048681
24. Orrow G, Kinmonth AL, Sanderson S, Sutton S. Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials. BMJ. 2012;344:e1389. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12012016191
25. Kassavou A, Turner A, French DP. Do interventions to promote walking in groups increase physical activity? A meta-analysis. International Journal of Behavioral Nutrition and Physical Activity. 2013;10:18. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12013017058
26. Brown DR, Soares J, Epping JM, Lankford TJ, Wallace JS, Hopkins D, et al. Stand-alone mass media campaigns to increase physical activity: a community guide updated review. American Journal of Preventive Medicine. 2012;43(5):551-61. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12012049318
27. Leavy JE, Bull FC, Rosenberg M, Bauman A. Physical activity mass media campaigns and their evaluation: a systematic review of the literature 2003-2010. Health Education Research. 2011;26(6):1060-85. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12012001737
28. Baker Philip RA, Francis Daniel P, Soares J, Weightman Alison L, Foster C. Community wide interventions for increasing physical activity. Cochrane Database of Systematic Reviews: Reviews. 2011;Issue 4. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=10000008366
29. Wu S, Cohen D, Shi Y, Pearson M, Sturm R. Economic analysis of physical activity interventions. American Journal of Preventive Medicine. 2011;40(2):149-58. http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=22011000314