Population strategy for promoting physical activity.

Physical inactivity is a globally prevalent phenomenon even though the health benefits of physical activity are well-known. The development of population strategies that effectively promote physical activity is necessary to reduce the individual and social burden of physical inactivity. Quality evidence informing strategies to promote physical activity at scale, however, is limited. Among cluster randomized trials examining the effectiveness of multistrategic, community-wide interventions aimed at promoting physical activity, only 1 trial (the COMMUNICATE study) successfully achieved a population-level increase in physical activity. This trial adopted social marketing techniques and network intervention (eg, word of mouth) in close collaboration with the target population (community residents). Although most previous studies ended their interventions within 1 to 3 years, the COMMUNICATE study took 5 years to achieve a population-level increase in physical activity. These findings suggest the need for a more focused approach (1 behavior at a time) as a basic marketing principle. Promoting physical activity at scale is a tough challenge but not impossible. Sophisticated approaches are necessary.