Theory-based behavioral intervention increases self-reported physical activity in South African men: a cluster-randomized controlled trial

Abstract

Objective: To determine whether a health-promotion intervention increases South African men's adherence to physical-activity guidelines.

Method: We utilized a cluster-randomized controlled trial design. Eligible clusters, residential neighborhoods near East London, South Africa, were matched in pairs. Within randomly selected pairs, neighborhoods were randomized to theory-based, culturally congruent health-promotion intervention encouraging physical activity or attention-matched HIV/STI risk-reduction control intervention. Men residing in the neighborhoods and reporting coitus in the previous 3 months were eligible. Primary outcome was self-reported individual-level adherence to physical-activity guidelines averaged over 6-month and 12-month post-intervention assessments. Data were collected in 2007-2010. Data collectors, but not facilitators or participants, were blind to group assignment.

Results: Primary outcome intention-to-treat analysis included 22 of 22 clusters and 537 of 572 men in the health-promotion intervention and 22 of 22 clusters and 569 of 609 men in the attention-control intervention. Model-estimated probability of meeting physical-activity guidelines was 51.0% in the health-promotion intervention and 44.7% in attention-matched control (OR=1.34; 95% CI, 1.09-1.63), adjusting for baseline prevalence and clustering from 44 neighborhoods.

Conclusion: A theory-based culturally congruent intervention increased South African men's self-reported physical activity, a key contributor to deaths from non-communicable diseases in South Africa.

Trial registration: ClinicalTrials.gov Identifier: NCT01490359.

Keywords: Binge drinking; Fruits and vegetables; Intervention study; Men; Physical activity; Randomized controlled trial; Social cognitive theory; South Africa; Theory of planned behavior.

Conflict of interest statement

Conflict of interest statement:

The authors declare that there are no conflicts of interest.

Copyright © 2014 Elsevier Inc. All rights reserved.

Figures

Figure 1

Progress of participating neighborhoods and men through the trial, Eastern Cape Province, South Africa 2007–2010. Eligible men not enrolled failed to return for intervention session 1 for unknown reasons. The enrollment rate did not differ between treatment (88.8%) and control (90.6%) arms, P = .2642). Men who did not complete the 6-month follow-up were deceased (n = 8) or in prison (n = 4), had permanently moved from the area (n = 21), or were absent from the scheduled follow-up sessions or make-up sessions for unknown reasons (n = 55). Men not followed up at 12 months were deceased (n = 14) or in prison (n = 2), had permanently moved from the area (n = 34), or were absent for unknown reasons (n = 25).