A multi-component, community-based outdoor gym intervention: the ecofit effectiveness trial

ABSTRACT

Introduction: In Australia, it is estimated that 45% of adults meet the aerobic training recommendations (i.e., 150-300 minutes of MVPA) and only 9-30% meet the resistance training (RT) guidelines (i.e., minimum 2 sessions/week). Given the lack of 'scalable' physical activity community-based interventions promoting RT, the aim of this effectiveness trial (based on the published ecofit efficacy trial) was to determine the effects of an innovative community-based multicomponent physical activity intervention promoting resistance and aerobic-based physical activity using outdoor gym equipment, smartphone technology, and social support. Method(s) The ecofit effectiveness trial was evaluated using a two-arm (intervention versus wait-list control) randomised controlled design, with assessments at baseline, 3 (primary time-point) and 9-months (follow-up). Participants were recruited from the Newcastle and Lake Macquarie local government areas, NSW. Eligible participants were aged 18-80 years, had access to a smartphone, did not meet the aerobic and/or resistance-based physical activity guidelines, and passed the Adult Pre-Exercise Screening Tool. The intervention components included (i) smartphone technology (i.e., purpose-built application that included standardised workouts using local outdoor gym equipment across 11 locations), (ii) social support (i.e., option to enrol as a group and join the ecofit Facebook group), and (iii) a 90-minute introductory session. Linear mixed models were conducted with an adjusted alpha (p<.025) to account for the two primary outcomes of upper (i.e., push-up test) and lower (sit-to-stand test) body strength. Result(s) Participants (N=245;mean age 53.44 (SD=13.9);72% women) were recruited. There were no statistically significant (p<.025) group-by-time effects for the primary outcomes (i.e., upper and lower body muscular fitness) at 3-months. At 9-months, however, there were significant improvements in both upper (1.42 repetitions, 95%CI=0.25, 2.59) and lower body (2.6 repetitions, 95%CI=0.41, 4.82) muscular fitness, compared to controls. Among the secondary outcomes at 3-months, mean differences in visceral adipose tissue (-59.52 grams, 95%CI=-122.17, 3.12), and total fat (-494.30 grams, 95%CI=-1012.39, 23.79) approached statistical significance (p's=0.06). Discussion/Conclusion: To our knowledge this is the first community-based RT intervention that has employed a scalable approach targeting the general population. Despite the mixed findings, it was encouraging to see beneficial effects on the primary outcomes, particularly in light of the disruption to the trial caused by the COVID-19 pandemic. The positive findings presented warrant further examination of this scalable intervention mode for its dissemination to other local government areas. Impact and application to the field * The ecofit program is promising with significant statistical and clinical effects and could be considered to be scaled-up in other Local Government Districts across Australia and abroad. This study was funded by NHMRC grant (APP1134914, 2017), registered with the Australian and NZ Clinical Trial Registry (ACTRN12619000868189) and received Human Ethics approval from the University of Newcastle (H-2018-0060). Conflict of interest statement My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this . Copyright © 2022