Effectiveness of physical activity promotion interventions in primary care: A review of reviews

•Physical activity promotion interventions in primary care are effective.•Interventions including multiple behavior change strategies obtain better outcomes.•Targeting interventions to those identified as insufficiently active maximizes results.•The most efficient intervention dose and format remain unclear.•Research focus should shift to implementation trials under routine clinical conditions.

ObjectiveThe present review aims to summarize the evidence about the effectiveness of physical activity (PA) promotion interventions in primary care (PC) and the intervention or sample characteristics associated with greater effectiveness.MethodsMEDLINE, EMBASE, and Cochrane Library were searched to identify systematic reviews and meta-analyses published from 2002 to 2012 that assessed the effectiveness of PA-promoting interventions in PC. Information was extracted and recorded about each of the selected studies and their reported results. Methodological and evidence quality was independently rated by two reviewers using the nine-item OQAQ scale and the SIGN classification system.ResultsTen of the 1664 articles identified met the inclusion criteria: five meta-analyses, three systematic reviews, and two literature reviews. Overall, PA promotion interventions in PC showed a small to moderate positive effect on increasing PA levels. Better results were obtained by interventions including multiple behavioral change techniques and those targeted to insufficiently active patients. No clear associations were found regarding intervention intensity or sample characteristics.ConclusionAlthough several high-quality reviews provided clear evidence of small but positive effects of PA intervention in PC settings, evidence of specific strategies and sample characteristics associated with greater effectiveness is still needed to enhance the implementation of interventions under routine clinical conditions.