Associations between awareness and stages of change in community-wide campaign to promote aerobic, flexibility, and muscle-strengthening activities in middle-aged and elderly people: Exploratory analyses of a cluster randomized controlled trial

Background: Examining the effectiveness of community-wide campaigns (CWCs) for promoting physical activity is important. This study aims to clarify the associations between awareness and stages of change in a CWC for promoting physical activity. Methods: A cluster randomized controlled trial was held using a population-based random-sampled evaluation from 40- to 79-year-old adults living in 12 communities in Unnan City, Shimane, Japan. A 1-year CWC was comprised of aerobic activity (Group A, 3 communities), flexibility and muscle-strengthening activities (Group FM, 3 communities), or all three (Group AFM, 3 communities), and included information, education, and support delivery, according to a social marketing process. In this study, awareness of the CWC and stages of change in regular aerobic, flexibility, and muscle-strengthening activities were analyzed using a generalized estimation equation and Kruskal-Wallis and Mann-Whitney tests. Results: The data of 3496 respondents were analyzed (control: 841; Group A: 895; Group FM: 857; Group AFM: 903). 79.2% of respondents in the intervention group were aware of the CWC (Group A: 82.0%; Group FM: 77.2%; Group AFM: 78.4%). The stages of change in each activity did not significantly differ between control and each intervention group at the follow-up. In Group A and AFM, respondents aware of the CWC were in higher stages of change in each activity. However, awareness of the CWC was not significantly associated with stages of change in flexibility and muscle-strengthening activities in Group FM. Conclusion: Awareness of the CWC was associated with stages of change in Group A and AFM.