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Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income Peoplesincluded New Zealand research and almost none have reported on the conduct andeffectiveness of culturally-specific interventions to increase physical activity. To addressthis gap in the evidence we conducted a brief environmental scan to identify culturallyspecificinterventions in NZ, and to determine the effectiveness of these.MethodsA brief review of the literature on physical activity programmes was conducted inScopus, alongside the author’s existing collection of papers on the topic. The literaturescan was undertaken in March 2009. For the international and national scans ofliterature, the Scopus bibliographical database was searched for papers since 1990 withcombinations of keywords: physical activity exercise, intervention, Māori, Pacific, culture.A Google search was also undertaken. For the New Zealand scan a review of the HEHAKnowledge library (www.heha.org.nz/index.php?id=346) was conducted, as well asmaking direct contact with physical activity researchers from Sport and Recreation NewZealand, Ministry of Health, and the Auckland University of Technology to identifypertinent literature. Titles of articles were scanned for relevance. Grey literature reportswere also used for this review.Literature scan: International contextThe effectiveness of physical activity interventionsThere is a growing body of evidence to support the effectiveness of interventions toincrease physical activity participation in general populations. One review 9 of theeffectiveness of various approaches to increasing physical activity found that twoinformational interventions (‘point-of-decision’ prompts to encourage stair use, andcommunity-wide campaigns) were effective; as were three behavioural and socialinterventions (school-based physical education, social support in community settings,and individually-adapted health behaviour change); and one environmental and policyintervention (creation of or enhanced access to places for physical activity combined withinformational outreach activities). The review also concluded that there was insufficientevidence to assess the effectiveness of a number of interventions, including classroombasedhealth education focused on information provision, and family-based socialsupport (because of inconsistent findings); mass media campaigns and college-basedhealth education and physical education (because of an insufficient number of studies);and classroom-based health education focused on reducing television viewing and videogame playing (because of insufficient evidence of an increase in physical activity). 9A review of evidence among adolescents 9 identified 57 studies: 33 aimed at children and24 at adolescents. Twenty-four studies were of high methodological quality, including13 studies in children. Interventions that were found to be effective achieved increasesranging from an additional 2.6 minutes of physical education related physical activity to283 minutes per week of overall physical activity. Among children, limited evidence foran effect was found for interventions targeting children from low socioeconomicpopulations, and environmental interventions. Strong evidence was found that schoolbasedinterventions with involvement of the family or community and multi-componentinterventions can increase physical activity in adolescents.171
Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income PeoplesWhile a number of studies have targeted specific ethnic groups such as African-American adults 11 12 , adolescents (The Memphis GEMS) 13 14 , or Latinos (Hip Hop tohealth), 15 16 there is limited description or evidence for culturally-specific interventions.Physical activity intervention research among minority populations has been limited andnot without methodological problems; however, more recent and well-designed studieshave begun to show positive results for interventions targeted to specific ethnicpopulations 17 . A meta-analysis 18 of psycho-behavioural(?) interventions to preventweight gain or reduce weight among US multi-ethnic and minority adults was recentlyconducted and included physical activity and nutrition components. Results showedsmall effect sizes (n=5, d = 0.08, 90% CI = -0.04, 0.35) for change in body weight withsingle component physical activity interventions and two component interventions (acombination of physical activity and/or nutrition and/or lifestyle change, and/orcounselling) (n=13, d = 0.22, 90% CI = 0.05, 0.4). Three component interventions,however, had a large effect size (n=6, d = 0.52, 90% CI = 0.39, 0.65). Interventionsconducted in individual sessions (n=15, d = 0.40, 90% CI = 0.24, 0.56) showed a highermean effect size than group interventions (n=9, d = 0.08, 90% CI = -0.04, 0.30).Interventions focused on an individual delivery basis would not be as consistent with aMāori or Pacific perspective, compared with group or whānau-based delivery.Based on the international studies reviewed, the following areas were highlighted forconsideration in future research:• theory-based intervention research,• more robust experimental design,• development and use of instruments that are valid and meaningful for the targetedpopulation,• longer follow-up,• investigaion of the impact of matching same ethnicity interventionist to participants’ethnicity, and• examination of the importance of tailoring interventions to each cultural subgroup.FeasibilityOnly a few studies have assessed the effectiveness of interventions to increase physicalactivity in minority groups; however, there is a dearth of evidence for the effectiveness ofcultural-specific interventions.SustainabilityA few examples of sustained interventions exist; however, issues related to sustainabilitywere not specifically addressed. Given adequate and ongoing resourcing andresponsiveness to community need, physical activity interventions would be sustainable.Effect on equityPhysical activity interventions have typically targeted non-ethnically diverse populationgroups or specific populations (those with cardiovascular disease, obesity etc.). Thedevelopment and implementation of culturally-specific interventions are likely to have apositive impact on equity.Acceptability to stakeholdersTargeted physical activity interventions have been generally received positively byparticipants.172
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