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A community-wide campaign to promote physical activity in middle-aged and elderly people: a cluster randomized controlled trial

Masamitsu Kamada12*, Jun Kitayuguchi3, Shigeru Inoue4, Yoshiki Ishikawa5, Hiromu Nishiuchi6, Shimpei Okada7, Kazuhiro Harada28, Hiroharu Kamioka9 and Kuninori Shiwaku1

Author Affiliations

1 Department of Environmental and Preventive Medicine, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan

2 Japan Society for the Promotion of Science, 5-3-1 Koujimachi, Chiyoda-ku, Tokyo 102-8471, Japan

3 Physical Education and Medicine Research Center UNNAN, 1212-3 Mitoya, Mitoya-cho, Unnan, Shimane 690-2404, Japan

4 Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan

5 Department of Public Health, Jichi Medical School, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan

6 Data Science Research Institute, 3-10-41 Minami-Aoyama, Minato-ku, Tokyo 107-0062, Japan

7 Physical Education and Medicine Research Foundation, 6-1 Nunoshita, Tomi, Nagano 389-0402, Japan

8 Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama 359-1192, Japan

9 Faculty of Regional Environment Science, Tokyo University of Agriculture, 1-1-1 Sakuragaoka, Setagaya-ku, Tokyo 156-8502, Japan

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International Journal of Behavioral Nutrition and Physical Activity 2013, 10:44  doi:10.1186/1479-5868-10-44

Published: 9 April 2013



We aimed to evaluate the effectiveness of a community-wide campaign (CWC) for promoting physical activity in middle-aged and elderly people.


A cluster randomized controlled trial (RCT) with a community as the unit of randomization was performed using a population-based random-sampled evaluation by self-administered questionnaires in the city of Unnan, Shimane Prefecture, Japan. The evaluation sample included 6000 residents aged 40 to 79 years. We randomly allocated nine communities to the intervention group and three to the control group. The intervention was a CWC from 2009 to 2010 to promote physical activity, and it comprised information, education, and support delivery. The primary outcome was a change in engaging in regular aerobic, flexibility, and/or muscle-strengthening activities evaluated at the individual level.


In total, 4414 residents aged 40–79 years responded to a self-administered questionnaire (73.6% response rate). Awareness of the CWC was 79% in the intervention group. Awareness and knowledge were significantly different between the intervention and control groups, although there were no significant differences in belief and intention. The 1-year CWC did not significantly promote the recommended level of physical activity (adjusted odds ratio: 0.97; 95% confidence interval: 0.84–1.14).


This cluster RCT showed that the CWC did not promote physical activity in 1 year. Significant differences were observed in awareness and knowledge between intervention and control groups as short-term impacts of the campaign.

Trial registration

UMIN-CTR UMIN000002683

Walking; Muscle stretching exercises; Resistance training; Musculoskeletal diseases; Health communication; Social marketing