Mediators of behaviour change maintenance in physical activity interventions for young and middle aged adults: a systematic review

Jennifer M Murray, Sarah F Brennan, David P French, Christopher C Patterson, Frank Kee, Ruth F Hunter

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)
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Background: Regular physical activity is important for maintaining physical and mental health. Benefits are  optimised when physical activity is maintained. Understanding causal mechanisms is important to inform  future interventions.   Purpose: To investigate mediators of physical activity maintenance.   Methods: Six databases were searched (Medline, EMBASE, PsycINFO, CINAHL, Cochrane Database of  Systematic Reviews, Web of Science). Eligibility criteria included: Adult non‐clinical populations; validated  measure of physical activity behaviour at baseline and at least six months post‐baseline; control/comparison  group(s); reported mediators of physical activity behaviour change. Mediators were examined according to: i)  formal mediation tests; ii) mediator association with physical activity outcome; iii) intervention effects on  mediators.   Results: There were few formal mediation tests conducted (n=12/39 included studies), and various other  methodological limitations were identified. There was some evidence that effective mediators in formal  mediation tests at six months and later included the ‘Behavioural processes of change’ (n=5/6). Many of the  included interventions were not effective for changing targeted mediators (only 34% of 413 tests of mediator  changes were significant).  Conclusions: There were a number of methodological and statistical limitations in the evidence base. In future,  pre‐specified formal mediation tests should be carried out and could be aided by a formal framework. Social  and environmental variables should be considered in addition to intrapersonal variables. Improving knowledge  of how to change hypothesised mediators, based on theory and evidence, will reveal how physical activity  behaviour change maintenance can be achieved. Maintenance research would be enhanced by establishing a  formal definition of behaviour change ‘maintenance’.  
Original languageEnglish
Pages (from-to)513-529
Number of pages17
JournalAnnals of Behavioral Medicine
Issue number6
Publication statusPublished - 17 Apr 2018


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