Acceptance and commitment-based approaches for promoting physical activity: a systematic review and narrative synthesis

Abstract

A systematic review of empirical studies that evaluated the efficacy of Acceptance and Commitment Therapy (ACT) to increase physical activity was conducted. The principle target outcome was engagement in physical activity or exercise. The main aim was to use systematic literature reviewing methods to provide a description of the current state of the evidence for ACT as a tool for this type of health promotion. Comprehensive searches of peer-reviewed literature to January 2016 were carried out using broad search criteria to maximise sensitivity. The identified literature was assessed again using specific criteria, independently applied by two reviewers. Subsequently, nine studies meeting the inclusion criteria were systematically evaluated for quality using the Effective Public Health Practice Project (EPHPP) quality assessment tool. Preliminary synthesis revealed population and methodological heterogeneity, which prevented the use of meta-analytical techniques. A systematic narrative synthesis was therefore developed. Six of the nine studies reported statistically significant increased physical activity in participants exposed to ACT-based interventions. Two out of three studies randomising participants to either a health promoting programme or the same programme plus ACT, reported statistically significant between group differences. Two studies using waitlist controls reported moderate effect sizes for ACT. Studies reporting increases in physical activity at long term follow-up, showed evidence of access to intervention material over an extended period. The review concluded ACT-based interventions can impact positively on levels of physical activity. Recommendations for future research based on dose response and use of comparisons when used as controls were made.