Pedometer Use Research Articles

Workplace pedometer interventions for increasing physical activity.

Workplace pedometer interventions for increasing physical activity.

Acceptability of the \u201cMOVEdiabetes\u201d physical activity intervention in diabetes primary care settings in Oman: findings from participants and practitioners

BackgroundAdequate physical activity (PA) is considered essential in diabetes management. However, evidence on the best method of promoting PA within diabetes care is inconclusive. The current work identifies perceptions on the acceptability of Intervention Group Participants (IGP) and Project Officers (POs) about the “MOVEdiabetes” intervention programme aimed at increasing PA in adults with type 2 diabetes in Oman (a retrospectively registered trial).MethodsThe “MOVEdiabetes” programme (PA consultations, pedometers and WhatsApp messages) was delivered by the POs (primary health care practitioners) in four primary care centres within a one-year cluster randomised control trial. Recruitment and retention were measured from trial attendance records. Programme satisfaction, appropriateness, and content suitability were assessed using exit surveys for both the IGP (interview based) and POs (self-administered). Open text questions on perceptions to the study programme were also included.ResultsParticipants were randomised to an intervention group (IG, n = 122) or comparison group (CG, n = 110). The overall retention rate at three and 12 months was 92.7% [110(90.2%) IG vs 105(95.5%) CG] and 75% [82(67.2%) IG vs 92(83.6%) CG] respectively. Most (n = 14, 87.5%) POs and more than half (n = 49, 59.8%) IGP perceived the programme as very appropriate and many reported that they were “quite/ very satisfied” with the programme (n = 16, 100% PO’s and n = 71, 86.6% IGP). Two thirds (n = 55, 66.0%) of IGP were very/quite likely to recommend the programme to others. PA consultations, use of pedometers and Whatsapp messages were well perceived by all. Participants recommended the inclusion of dietary advice and PA promotion for the general public. Exploring PA facilities within the community was suggested by POs.ConclusionsThe “MOVEdiabetes” programme achieved a high retention rate and was perceived as satisfactory and appropriate. Results from this study suggest that it is worthwhile exploring the use of the “MOVEdiabetes” programme in clinical practice and further community links.Trial registrationInternational Standard Randomised Controlled Trials No: ISRCTN14425284. Registered retrospectively on 12th April 2016.

688-P: Promoting Long-Term Physical Activity in Prediabetes: The PROPELS RCT

Objective: Walking Away from Diabetes (Walking Away) is a low resource 3-hour group-based behavioural intervention designed to promote physical activity through pedometer use in those with prediabetes. This trial aimed to investigate whether Walking Away leads to sustained increases in physical activity when delivered with and without an integrated mHealth intervention compared to control. Methods: Those with a history of prediabetes (HbA1c ≥42 [6.0], <48 [6.5] mmol/mol [%]) were recruited from family practices, England. Participants were randomised to: control (CON), Walking Away (WA) or Walking Away Plus (WA+). CON received an information leaflet, WA the Walking Away programme with annual group-based support, and WA+ the Walking Away programme with an mHealth intervention providing automated individually tailored text messages to prompt pedometer use, goal setting and provide feedback; texts were supported by telephone calls (2 per year). The primary outcome was accelerometer measured ambulatory activity (steps/day) at 48 months. The proportion achieving 150 min/week of moderate to vigorous intensity physical activity (MVPA) were also assessed. Follow-up was conducted at 12 and 48 months. Results: 1366 individuals were randomised (median age = 61 years, BMI = 28.4 kg/m2, ambulatory activity = 6638 steps/day, women = 49%, black and minority ethnicity = 28%). Accelerometer data were available for 1017 (74%) and 993 (73%) individuals at 12 and 48 months, respectively. At 12 months, WA+ increased their ambulatory activity by 547 (97.5% CI, 211, 882) steps/day compared to CON and were 1.61 (97.5% CI 1.05, 2.45) times more likely to achieve 150 min/week of MVPA. However, differences were not sustained at 48 months. There were no differences between WA and CON at 12 or 48 months. Conclusion: Combining a physical activity intervention with text messaging and telephone support resulted in modest, but clinically meaningful, changes in physical activity at 12 months, but changes are not sustained after 48 months. Disclosure K. Khunti: Advisory Panel; Self; Amgen, AstraZeneca, Bayer AG, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Menarini Group, Merck Sharp 0026& Dohme Corp., Napp Pharmaceuticals, Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi-Aventis, Servier. Board Member; Self; AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi-Aventis. Consultant; Self; Amgen, AstraZeneca, Bayer AG, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Menarini Group, Merck Sharp & Dohme Corp., Napp Pharmaceuticals, Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi-Aventis, Servier. Research Support; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis, Servier. Speaker’s Bureau; Self; Amgen, AstraZeneca, Bayer AG, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Menarini Group, Merck Sharp & Dohme Corp., Napp Pharmaceuticals, Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi-Aventis, Servier. S. Griffin: Speaker’s Bureau; Self; AstraZeneca, Napp Pharmaceuticals. Other Relationship; Self; Eli Lilly and Company. M.J. Davies: Advisory Panel; Self; Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi, Sanofi US. Speaker’s Bureau; Self; Boehringer Ingelheim International GmbH, Napp Pharmaceuticals, Novo Nordisk A/S, Sanofi. Other Relationship; Self; Ingeus UK. H.C. Eborall: None. C. Edwardson: None. W. Hardeman: None. J. Henson: None. S. Sharp: None. S. Sutton: None. J. Troughton: None. T. Yates: Research Support; Self; AstraZeneca. Other Relationship; Self; Ingeus UK. Funding National Institute for Health Research

The Use of Pedometer as a Stimulus to the Physical Activity in the Hypertensive Patients with Difficult-to- Control Hypertension: A Controlled Randomized Study

Regular physical activity contributes to better control of hypertension in addition to other dietary measures and medications. The practice of physical activity and long term adherence to it is not consistently observed in a hypertensive population. We evaluated the possible role of the use of a pedometer as a stimulus to enhance the physical activity in a selected hypertensive population.We performed a prospective, randomized trial in a difficult-to-control hypertensive population that had been followed in the hypertensive clinic of the Hospital Santa Izabel of Santa Casa de Misericórdia da Bahia. This study compared two groups: Pedometer Group, which uses a pocket digital pedometer (Omron HJ-321) in addition to the usual medical recommendation; and Control Group, which was submitted to the regular medical recommendation without a pedometer. The performance was analyzed by the number of steps during 12 weeks observation period with the primary endpoint at first week. Forty-two patients were studied. Patients had largely low-income and low-education characteristics. Their initial number of steps at week 1 were: 6,191.7 (667.3), and 5,249.1 (549.5) for the Control and Pedometer Groups (p=0.28), respectively. At the end of a 12-week observation, the results were: 6,097.6 (547.0), and 5,913.0 (730.6) (p=0.84) for the Control and Pedometer Groups, respectively. In a population of difficult-to-control hypertension, which already had a relatively high number of steps to perform its regular activities of day-life at the beginning of the study, the use of a pedometer does not seem to enhance the level of physical activity beyond what is accomplished by the structured information that is provided in the hypertension clinic.

Every Step Counts: Understanding the Success of Implementing The 10,000 Steps Project.

The 10,000 Steps program originated from a landmark whole-of-community multi-strategy intervention to increase physical activity (PA) in Rockhampton, Australia in 2001-2003. It used a social ecological framework to promote physical activity at the individual, population, environmental and policy level. Two of the fundamental aspects of the original program were goal setting (10,000 steps per day) and self-monitoring (use of a pedometer for daily step counts). A project website (www.10000steps.org.au) allowed registered participants to record their physical activity. Over time the program morphed into an e- & mHealth intervention without face-to-face elements. The program is now delivered via website and smartphone apps and employs activity trackers (pedometers, Fitbit, Garmin). To date the project has signed-up over 425,000 members who have logged 221 billion steps (∼43 million a day) on the website or app. More than 14,000 workplaces and community organisations have been involved with the program. A central element of the program, the 'Workplace Challenge' has been used by ∼65% of 10,000 Steps members, which on average increases physical activity by 159 min/week for those who participate in it. In 2011, the Queensland Government designated the 10,000 Steps program as their key physical activity workplace health promotion strategy. Multiple factors underpin the success of the program. The message is simple and clear: the project name, with its distinctive logo and tagline ('Every Step Counts') provides a clear and prescriptive target for the physical activity 'dose'. Using effective behaviour change techniques: goal setting (the 10,000 Steps concept), self-monitoring (steps are tracked), social support (participants organise as 'teams' to reach certain step goals) and gamification (teams competing against each other creating 'friendly competition'). Ongoing redevelopment: since inception, there have been three complete redesigns of the website (including a branding redesign), and new smartphone apps. More recently, the website was modified to allow syncing of steps using popular activity trackers. Resources to support implementation: the program provides resources (e.g. 'Active Workplace Guide') and has dedicated staff to respond to queries from workplaces and individuals to help overcome implementation barriers. Project staff continuously promote the program via media interviews, attendance at events, social media and marketing, advertising, and networking and collaboration. Ongoing evaluation has contributed to continuous funding: to ensure the program remains successful in a fast-changing technology environment, continuous evaluation has been necessary. These evaluation strategies, the success of the original project and the strong partnership with the program funder (Queensland Health) have all contributed to the long-term (19 years) support for the project.

Use of Pedometer Following Radical Prostatectomy

Use of Pedometer Following Radical Prostatectomy

Use of pedometers as a tool to promote daily physical activity levels in patients with COPD: a systematic review and meta-analysis.

The aim of this study was to examine the use of pedometers as a tool to promote daily physical activity levels in patients with COPD.A systematic review meta-analysis of pedometer physical activity promotion in patients with COPD was conducted. Medline/PubMed, Cochrane Library, Web of Science and CINAHL were searched from inception to January 2019. The search strategy included the following keywords: physical activity promotion, pulmonary rehabilitation and daily physical activity. The eligibility criteria for selecting studies were randomised controlled trials reporting pedometer physical activity promotion in patients with COPD.Improvements in steps per day were found with pedometer physical activity promotion either standalone (n=12, mean 0.53 (95% CI 0.29-0.77); p=0.00001) or alongside pulmonary rehabilitation (n=7, 0.51 (0.13-0.88); p=0.006). A subgroup analysis reported significant differences in the promotion of physical activity based on baseline physical activity levels and the type of instrument used to assess levels of physical activity.Future trials should consider the way in which pedometers are used to promote physical activity to inform clinical practice in the setting of pulmonary rehabilitation.

RESULTS FROM RESEARCH ON A HEALTH-COACHED WALKING PROGRAM IN FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA

Caregivers of persons with dementia demonstrate increased levels of stress, anxiety and depression, placing them at increased risk for poor health-related outcomes. Walking is widely supported as a cost-effective, accessible exercise and way to maintain physical fitness and mitigate stress levels. There is a critical gap in addressing health promotion strategies in caregivers. The specific aims of this health-coaching (HC) walking study using wireless pedometers in family caregivers of persons with dementia were to: 1) establish the feasibility of HC and wireless pedometer use, 2) examine outcomes of well-being, stress and activity level and 3) understand the experience of participation. This 2-group comparative study used a repeated measure design and mixed methods approach. We enrolled 27 females and 5 male caregivers (n=32), μ age 57 years: with both 16 in the control in the intervention arm. Pre-post measures of general health (body mass index [BMI], blood pressure, heart rate, cognition, well-being, stress and perceived activity level) were obtained from caregivers at baseline and again at 12 weeks. Results indicate that those who received HC had a statistically significant improvement in BMI (p = .01). There were no other statistically significant improvements in outcomes in either group. Qualitative findings suggest that participants reported many stresses that made self-care challenging. In summary, this was a feasible intervention that resulted in improved BMI in the HC group. Work is needed to understand the long-term impact of this outcome. Further exploration of other health-promoting interventions that may be beneficial for this population is essential.

SAT-389 Evaluation of the Hypothalamic-Pituitary-Adrenal Axis and Physical Performance in Older Adults

INTRODUCTION: Blunting of the circadian rhythm of the hypothalamic–pituitary– adrenal (HPA) axis is known to occur with aging, although a pathological overall increase in glucocorticoid secretion is rare in elderly. Persistently high levels of cortisol are associated with increased catabolism of skeletal muscle, so that a link between chronically elevated cortisol and frailty is biologically plausible in this population. OBJECTIVE: We aimed to investigate the relationships between the activity of the HPA axis, determined the diurnal cortisol release pattern and DHEA secretion, and physical performance in older adults. METHODS: A total of 69 elderly (65.2% female), aged 60-84 years, with normal cognition and functionally healthy, with a median BMI of 27.3 kg/m2 (ranging from 19.1 to 38.6), were enrolled. Physical performance was tested by: a) number of steps per day measured by a pedometer during 3 consecutive working days; b) Sitting-Rising Test (SRT); c) Single-Leg Stance (SLS); d) Timed Up and Go (TUG); e) One-Repetition Maximum Test (1RM); f) Six Minute Walk Test (6MWT). Individuals were considered active when mean daily steps was ≥7,000 steps, and insufficiently active when <7,000 steps. Salivary cortisol (sC) was collected 30min after awakening, at 11 a.m., 5 p.m. and 9 p.m. and before bedtime in the third day of the pedometer use, and blood samples for serum DHEA concentration were collected on a subsequent day. Non-parametric Mann-Whitney test and Spearman correlation test, when applicable, were used for statistical analysis. Area under curve (AUC) was calculated for determination of the diurnal cortisol release pattern. RESULTS: A total of 41 individuals (59.4%) were classified as insufficiently active, and 28 as active (40.6%), according to pedometer-assessed steps per day. Active elderly exhibited a better balance and performance in the 1RM Test (p=0,05) than inactive. A worse performance in the 1RM Test was observed in individuals with higher sC at 11 a.m and in those with a larger AUC of sC (p<0,05). In addition, individuals with lower serum DHEA concentration exhibited a worse performance at the 6MWT (p=0.03). CONCLUSION: Our findings support the association between spontaneous physical activity levels, assessed by the pedometer daily steps measurement, and functional performance in elderly. In addition, higher diurnal cortisol secretion and lower DHEA plasmatic levels were associated with a lower physical performance in older individuals.

The Effect of Physical Education Teacher Physical Appearance on Student Physical Activity

The purpose of this study was to examine how perceptions of a physical educator's physical appearance affected student physical activity levels through the use of pedometers. It was hypothesized that students with a fit-appearing teacher would have higher step counts than students with an overweight-appearing teacher. Both male and female students (N = 142) from fourth-, fifth-, and sixth-grade physical education classes wore pedometers during physical education class. Initially, students completed a Figure Rating Scale that rated a set of two cartoon figures in order to determine weight bias. A Zumba lesson was taught by one female guest teacher who wore a fat suit for half of the classes and no fat suit for the other half of the classes separately. Following the lesson, students completed a Student Attitude Questionnaire regarding the guest teacher and asked to record step count from their pedometer. A 3 x 2 x 2 ANCOVA data analysis revealed a statistically significant grade x group interaction (F [2,129] = 6.48, p = .002, ETA = .091). The covariate Student Attitude Questionnaire showed statistical significance (F [1, 129] = 9.23, p = .003, ETA = .067). The results of this study showed that the fourth graders had a higher step/min. in the group with the fit-appearing teacher and lower step/min. in the group with the overweight-appearing teacher. However, it was the opposite with the sixth graders, as the group with the fit-appearing teacher had lower step/min. than the group with the overweight-appearing teacher. The results of this study indicate that a fit teacher appearance may have a greater direct relationship with fourth-grader physical activity, but fit-appearing teachers may actually relate to lower levels of physical activity in sixth graders. These phenomena may be influenced by preactivity weight bias in children.

Effectiveness of Pedometer-Based Walking Program to Improve Physical Activity of Workers in a Software Industry: An Experimental Study.

Background:Workplace acts as an efficient target for health promotion activities. Pedometer can act as a motivator and monitor of physical activity.Aims:The aim of the study was to assess the effect of pedometer usage in increasing physical activity and the level of adherence among employees of a software company in Puducherry.Methods:An interventional study was conducted with a prepost design. A single group of software company employees (n = 46), age ≥30 years selected by simple random sampling, was included in the study. Intervention consisted of health education program on physical activity, goal setting, and instructions regarding the use of pedometers for 1 week. Physical activity levels were measured at baseline and endline using global physical activity questionnaire.Results:Out of the 46 participants, 93% of the participants used the pedometer for at least 6 days. The difference between maximum observed step count during the week (median 9834 steps) and at baseline (6963 steps) was significant. Overall, 93.5% found pedometers to be useful for improving physical activity. Proportion of individuals with adequate physical activity based on Metabolic equivalents (MET) minutes increased from 41.3% (n = 19) at baseline to 69.6% at endline (n = 32) (P = 0.004).Conclusions:This study shows that a pedometer-driven walking intervention in the workplace setting is feasible and effective in increasing physical activity over a short term. Further research is required to test the effect of supportive strategies and long-term effectiveness of pedometer use.

SMART goals setting and biometric changes in obese adults with multimorbidity: Secondary analysis of a randomized controlled trial.

Objectives:Clinicians recommend diet and exercise for overweight/obese patients. We conducted a secondary analysis of a randomized controlled clinical trial evaluating goal setting and pedometer use versus usual care on weight, waist circumference, and blood pressure of patients with multiple chronic conditions.Methods:In this trial, we recruited and randomized patients over 18 years with multiple chronic conditions. There were two groups with an immediate intervention group who received behavioral coaching and a pedometer versus a delayed control who received the intervention after 2 months. We evaluated body weight, waist circumference, and blood pressure as outcomes. We used analysis of covariance to evaluate differences between the intervention and the control groups.Results:Of 130 patients, mean age was 63.4 years (SD, 17.3). At 2 months, intervention participants lost 0.2 kg versus a 0.1-kg gain in the control participants (P = .44). The immediate intervention group had significantly smaller waist circumference change at 2-month follow-up compared to control at −1.6 cm (95% confidence interval = −3.1 to −0.1), which was driven by an increase in waist circumference in the delayed control group. No difference in systolic blood pressure was observed.Discussion:We observed no difference in weight or blood pressure between the groups with obesity and multiple chronic conditions.

Efficacy of Wearable Devices to Measure and Promote Physical Activity in the Management of Diabetes

Physical inactivity is a global health problem that contributes to the increasing risk of obesity and diabetes. Wearable devices are defined as technologies that can be comfortably worn on the body and that are designed to be effective at improving the health and overall fitness of the wearer. The aim of this narrative review is to summarise the current studies investigating the efficacy of wearable devices, especially mobile applications, for the management of diabetes. The use of pedometers or accelerometers has been shown to increase physical activity by approximately 1 hour per week; however, rates of obesity and diabetes were not affected. Although recent assessments of the effect of smartphone applications on physical activity and glycaemic control are sparse, they are useful for promoting physical activity and for treating diabetes. The interactions with patients using wearable devices for self-monitoring, education, and coaching are essential for the improvement of diabetes. However, there are currently no clinical trials investigating the efficacy of the ‘perfect’ wearable device, whereby patients with diabetes can accurately and comfortably monitor their physical activity, energy balance, blood pressure, heart rate, and blood glucose level. Analysis of big data from wearable device users will contribute to the development of effective wearable devices. Developments in wearable technology are anticipated and further studies will be required to assess the efficacy of wearable devices in measuring and promoting physical activity in the management of diabetes.

Examining adherence to activity monitoring devices to improve physical activity in adults with cardiovascular disease: A systematic review.

Activity monitoring devices are currently being used to facilitate and monitor physical activity. No prior review has examined adherence to the use of activity monitoring devices amongst adults with cardiovascular disease. Literature from June 2012 to October 2017 was evaluated to examine the extent of adherence to any activity monitoring device used to collect objective physical activity data. Randomized control trials comparing usual care against the use of an activity monitoring device, in a community intervention for adults from any cardiovascular diagnostic group, were included. A systematic search of databases and clinical trials registers was conducted using Joanna Briggs Institute methodology. Of 10 eligible studies, two studies reported pedometer use and eight accelerometer use. Six studies addressed the primary outcome. Mean adherence was 59.1% (range 39.6% to 85.7%) at last follow-up. Studies lacked equal representation by gender (28.6% female) and age (range 42 to 82 years). This review indicates that current research on activity monitoring devices may be overstated due to the variability in adherence. Results showed that physical activity tracking in women and in young adults have been understudied.

Empowering aspects for healthy food and physical activity habits: adolescents’ experiences of a school-based intervention in a disadvantaged urban community

ABSTRACTPurpose:This study aimed to describe adolescents’ experiences of participating in a health-promoting school-based intervention regarding food and physical activity, with a focus on empowering aspects. Method: The school was located in a urban disadvantaged community in Sweden, characterized by poorer self-reported health and lower life expectancy than the municipality average. Focus group interviews with adolescents (29 girls, 20 boys, 14–15 years) and their teachers (n = 4) were conducted two years after intervention. Data were categorized using qualitative content analysis. Results: A theme was generated, intersecting with all the categories: Gaining control over one’s health: deciding, trying, and practicing together, in new ways, using reflective tools. The adolescents appreciated influencing the components of the intervention and collaborating with peers in active learning activities such as practicing sports and preparing meals. They also reported acquiring new health information, that trying new activities was inspiring, and the use of pedometers and photo-food diaries helped them reflect on their health behaviours. The adolescents’ experiences were also echoed by their teachers. Conclusions: To facilitate empowerment and stimulate learning, health-promotion interventions targeting adolescents could enable active learning activities in groups, by using visualizing tools to facilitate self-reflection, and allowing adolescents to influence intervention activities.

2460 Qualitative study of obesity risk perception, knowledge, and behavior among Hispanic taxi drivers in New York

2460 Qualitative study of obesity risk perception, knowledge, and behavior among Hispanic taxi drivers in New York

The Effects of Pedometers on Body Weight and Metabolic Factors in Patients with Prediabetes

: Sedentary behavior, increased total body weight, elevated blood glucose levels and hyperlipidemia increase the risk of prediabetes. Individuals diagnosed with prediabetes (fasting blood glucose (FBG) between 100-125mg/dL) are recommended to perform a minimum of 150 minutes of physical activity (PA) per week and decrease total body weight by 7% to reduce the likelihood of developing type 2 diabetes. However, there is little known about the role of pedometers with regards to a Diabetes Prevention Program (DPP) PURPOSE: To determine if pedometer use could aid in the reduction of total body weight, cholesterol, and blood glucose levels as a part of the Centers for Disease Control National DPP. METHODS: Body weight, FBG and lipids (total cholesterol, high-density lipoproteins (HDL) and low-density lipoproteins (LDL)) were measured prior to the start of the DPP and 16 weeks following the intervention. All participants were either diagnosed as prediabetic or at risk for prediabetes based on the CDC screening tool. The pedometer group (PG) (n=9) received pedometers and the control group (CG) (n=8) did not. All participants received the same educational sessions that explained dietary changes and strategies to increase PA. The PG was asked to wear a pedometer on their belt for all waking hours of the day, seven days a week, for sixteen weeks. At each weekly DPP meeting, step counts from pedometers were recorded and pedometers were reset and returned to the participants. A 2x2 ANOVA was performed to examine differences. RESULTS: The PG experienced significant (p<0.05) weight loss from pre to post-test (186.2lbs + 9.7 to 180.7 + 8.9) while the control group did not (191.3lbs + 16.8l to 190.1 + 17.0). Interestingly, HDL significantly decreased from pre to post-test (p>0.05) in the PD group (58.1mg/dL + 4.0 to 54.1mg/dL + 3.6) while the CG remained unchanged (50.9mg/dL + 5.1 to 50.5mg/dL + 4.8). There were no differences between any other variables. CONCLUSION: It appears that the addition of pedometers into the DPP can contribute positively to weight loss. It is possible participants experienced a sense of greater accountability due to the added tracking tool. Further research and a larger participation population is needed to elucidate the mechanisms that contribute to the changes in body weight and lipid profile.

Relating process evaluation measures to complex intervention outcomes: findings from the PACE-UP primary care pedometer-based walking trial

BackgroundThe PACE-UP trial demonstrated positive effects of a pedometer-based walking intervention on objective physical activity (PA) outcomes at three and 12 months in 45–75-year-old primary care patients, in postal and nurse-supported trial arms compared with controls. We explored associations between process evaluation measures and change in PA outcomes.MethodsThe MRC framework guided process evaluation. Three quantitative measures (nurse session attendance [dose delivered], PA diary completion [fidelity] and pedometer use [fidelity]) were selected as independent variables in multi-level models estimating intervention effectiveness on PA outcomes (changes in step-counts and time in moderate-to-vigorous PA [MVPA] levels in ≥ 10-min bouts).ResultsDose: attending all three nurse sessions compared with 0–2 sessions was associated with an increase in steps/day at three and 12 months of 1197 (95% confidence interval [CI] = 627–1766) and 605 (95% CI = 74–1137), respectively; and MVPA in bouts (min/week) at three and 12 months by 74 (95% CI = 45–103) and 30 (95% CI = 3–57), respectively. Fidelity: postal and nurse groups showed strong positive associations of diary return with steps/day at three months: postal 1458 (95% CI = 854–2061), nurse 873 (95% CI = 190–1555). MVPA in bouts (min/week): postal 64 (95% CI = 33–94), nurse 50 (95% CI = 15–85). At 12 months, only the postal group effects remained statistically significant: steps/day 1114 (95% CI = 538–1689), MVPA 47 (95% CI = 18–75). Regular pedometer use in the postal group only was associated with higher three-month and 12-month steps/day: 1029 (95% CI = 383–1675) and 606 (95% CI = 22–1190), respectively, and with MVPA in bouts at three months: 40 (95% CI = 6–73).ConclusionProcess evaluation measures demonstrated significant associations with PA outcomes at three and 12 months. We cannot infer causality, but the associations between the process measures and PA outcomes suggest that they were important in enabling the trial changes observed and should be considered core components of the PACE-UP nurse and postal interventions. We have shown the MRC framework to be a useful tool for process evaluation of intervention implementation.Trial registrationISRCTN Registry, ISRCTN98538934. Registered on 2 March 2012.

Using the Health Belief Model, Could the Use of Pedometers Encourage Physical Activity in Adults with Sedentary Occupations and Associate to a Reduction in Obesity and Weight Gain?

Aim: The aim of this paper is to examine how the Health Belief Model can be used to demonstrate the benefits of pedometer use for sedentary working adults to aid in decreasing obesity and weight gain. Introduction: Pedometers have grown to be a popular tool to track steps resulting in demonstrating the number of calories burned from the number of steps tracked. Methods: There will also be a breakdown of pedometer use in different circumstances that document and demonstrate the benefits of using pedometers to reduce a sedentary lifestyle. Using the Health Belief Model, the concepts that will be analyzed will be: individual perceptions; modifying actions; and likelihood of change. Conclusion: Pedometer use could begin the process of lowering the prevalence of ailments that can lead to death.

Pedometers as an Effective Tool for Measuring Physical Activity in Young Females in Saudi Arabia

Background: Pedometers are inexpensive and valid tools for monitoring physical activity. This study aimed to validate pedometers as an alternative option to Arab Teens Lifestyle (ATLS) questionnaire for evaluating physical activity in Saudi Arabia young women. Methods: Ninety-nine female students, aged 19-23, were recruited at a female University in Riyadh, in Saudi Arabia. Participants wore HJ-203 OMRON pedometer for 7 consecutive days and at the end, they completed the part of ATLS questionnaire related to physical activity. Results: Step count was significantly associated with total time spent on all physical activities (r=0.284; p=0.027) and time spent on high-intensity physical activities (r=0.308; p=0.006) but not with time spent on moderate-intensity physical activities (r=0.184; p=0.145). Step count showed a significant association with time spent in walking (r=0.289; p=0.008), one of the most frequent activities. Mean step count, low in both groups, was significantly higher in the group of active students compared to the inactive (6447±2426 vs 5035±2426; p=0.029). Conclusion: This study encourages the use of pedometers instead of questionnaires to evaluate physical activity. Pedometers can also be a useful tool to promote physical activity in a population of Arab young female students, where walking is the most usual form of exercising.