Getting started--a review of physical activity adoption studies.

The aim of this paper has been to review methods that have been found to be effective in getting sedentary adults to adopt physical activity, to examine these methods within the multilevel framework conceptualised by Winett et al, and to provide recommendations for future research to test new methods and their effectiveness in leading to the adoption of physical activity in sedentary populations. Searches for relevant studies were conducted on the Medline computerised database. Additional studies were located in reference sections of these studies and other review papers. Surveys that specifically identified determinants of adoption of physical activity in adults were included. Reviewed articles were selected on the basis of quasi-experimental and experimental designs that specifically examined the question of how to get sedentary adults to adopt a programme of physical activity or exercise, had completely described methods, and evaluated the effectiveness of methods of increasing physical activity and/or exercise. While numerous reviews have been written on determinants on physical activity adoption and maintenance, only two prospective surveys have identified specifics of adoption of physical activity. Most of the evidence for techniques that help inactive people to adopt physical activity comes from quasi-experimental and experimental intervention studies examining various cognitive and behavioural strategies at the individual level. Fewer studies have examined techniques at the interpersonal, organisational, community, environmental, and policy level. More prospective observational studies aimed at homogeneous subgroups are needed to identify correlates of physical activity adoption to help tailor interventions. Continued clinical studies are needed to differentiate the necessary and sufficient strategies at the personal and interpersonal levels. Interventions aimed at environmental, institutional, and social levels remain largely unexplored and there is a need for more research that specifically targets inactive subgroups at these levels.