Comparison of two email-delivered, pedometer-based interventions to promote walking among insufficiently active women. Move to Improve: a randomized workplace trial to increase physical activity. A randomized trial of telephonic counseling plus walking for depressed diabetes patients. Growing healthy families: family use of pedometers to increase physical activity and slow the rate of obesity. Impact of Promoting Lifestyle Activity for Youth (PLAY) on children's physical activity. Effect of individual counseling on physical activity fitness and health: a randomized controlled trial in a workplace setting. Effects of "10,000 steps Ghent": a whole-community intervention. The effectiveness of interventions to change six health behaviours: a review of reviews. Effects of integrating pedometers, parental materials, and E-mail support within an extracurricular school sport intervention. Both resistance and agility training reduce back pain and improve health-related quality of life in older women with low bone mass. Efficacy of a workplace-based weight loss program for overweight male shift workers: the Workplace POWER (Preventing Obesity Without Eating like a Rabbit) randomized controlled trial.
Research on the effect of email-delivered, pedometer-based interventions on walking behavior and transtheoretical model (TTM) constructs is lacking. Therefore, the purpose of this study was to compare the effectiveness of two email-delivered, pedometer-based interventions designed to increase walking and TTM construct scores among insufficiently active women. Participants were randomly assigned to one of two 6-week intervention groups. Both groups wore pedometers, submitted step logs, and received weekly email reminders. One group also received in the emails suggested strategies based on TTM for increasing physical activity. Of the 74 women who began the study, 56 (age=41.5+/-7.6 years; body mass index=31.2+/-6.6kg/m(2); 86% Caucasian) completed the International Physical Activity Questionnaire and TTM questionnaires at baseline and post-intervention. Participants in both groups combined increased weekly time spent walking (p=0.002) and their scores on TTM cognitive processes, behavioral processes, pros, and cons changed (p< or =0.001) from baseline to post-intervention. The changes in walking and TTM scores did not differ between groups (p>0.05). The results of this study indicate that email-delivered, pedometer-based interventions may impact walking and most TTM scores among insufficiently active women. Although preliminary, the findings provide additional evidence that this low-cost method of intervening may be an effective approach to combat physical inactivity in women. Workplaces are important settings for interventions to increase physical activity, but effects have been modest.
                To evaluate the efficacy of Move to Improve, a social-ecologic intervention delivered at the workplace to increase leisure-time physical activity.
                A group-randomized 12-week intervention consisting of organizational action and personal and team goal-setting was implemented in Fall 2005, with a multi-racial/ethnic sample of 1442 employees at 16 worksites of The Home Depot, Inc. Change in physical activity was analyzed in Fall 2007 using latent growth modeling and latent transition analysis.
                Participants in the intervention had greater increases in moderate and vigorous physical activity and walking compared to participants in a health education control condition. The proportion of participants that met the Healthy People 2010 recommendation for regular participation in either moderate or vigorous physical activity remained near 25% at control sites during the study but increased to 51% at intervention sites. During the last 6 weeks of the study, intervention participants exceeded 300 weekly minutes of self-reported moderate-to-vigorous physical activity and 9000 daily pedometer steps.
                The results support the feasibility and efficacy of the Move to Improve intervention and the role of goal-setting for attaining increased physical activity levels. Patients with diabetes and depression often have self-management needs that require between-visit support. This study evaluated the impact of telephone-delivered cognitive behavioral therapy (CBT) targeting patients' management of depressive symptoms, physical activity levels, and diabetes-related outcomes.
                Two hundred ninety-one patients with type 2 diabetes and significant depressive symptoms (Beck Depression Inventory scores ≥ 14) were recruited from a community-based, university-based, and Veterans Affairs health care systems. A manualized telephone CBT program was delivered weekly by nurses for 12 weeks, followed by 9 monthly booster sessions. Sessions initially focused exclusively on patients' depression management and then added a pedometer-based walking program. The primary outcome was hemoglobin A1c levels measured at 12 months. Blood pressure was a secondary outcome; levels of physical activity were determined by pedometer readings; depression, coping, and health-related quality of life were measured using standardized scales.
                Baseline A1c levels were relatively good and there was no difference in A1c at follow-up. Intervention patients experienced a 4.26 mm Hg decrease in systolic blood pressure relative to controls (P=0.05). Intervention patients had significantly greater increases in step counts (mean difference, 1131 steps/d; P=0.0002) and greater reductions in depressive symptoms (58% remitted at 12 mo vs. 39%; P=0.002). Intervention patients also experienced relative improvements in coping and health-related quality of life.
                This program of telephone-delivered CBT combined with a pedometer-based walking program did not improve A1c values, but significantly decreased patients' blood pressure, increased physical activity, and decreased depressive symptoms. The intervention also improved patients' functioning and quality of life. We conducted a study to determine if wearing a pedometer affects weight, body mass index (BMI), or mediators of physical activity among families.
                Eighty-seven families were randomized to 1 of 3 treatments: pedometer plus education (PE), pedometer (P), or control (C). Participants in the PE and P groups wore pedometers and were encouraged to walk 10,000 steps daily for 12 weeks. PE group participants attended 6 sessions on healthy eating and exercise. Participants were surveyed about their knowledge and attitudes about healthy eating and physical activity prior to randomization, at the end of the intervention, and 9 months later. Their heights and weights were measured and BMI calculated.
                Children's BMI percentile decreased from baseline to end of intervention (-0.18%) and at 9-month follow-up (-0.08%) but did not differ by treatment. Children's BMI percentile varied by parental obesity status (average BMI percentile was 88.7% for children of obese parents and 78.5% for children of non-obese parents). Parents' weight decreased slightly by intervention's end (0.6 pounds) and at 9 months (1.2 pounds), but change was similar among groups. Attitudes about their physical activity level relative to their peers improved significantly among children and parents wearing the pedometer. Self-efficacy improved for parents wearing the pedometer. Both children and parents felt the pedometer increased their activity level, but most were unlikely to wear it beyond the intervention.
                The pedometer had little impact on the activity level, weight, or BMI of participants. This study examined effects of a school-based intervention called PLAY (Promoting Lifestyle Activity for Youth) on physical activity levels and body mass index (BMI) of students. Participants included 606 fourth-grade students selected from a stratified sample of 35 schools in Arizona and placed into four groups: PLAY & PE, PLAY Only, PE Only, and No Treatment. A treatment-control, post-measurement design assessed physical activity using the YAMAX pedometer, and height and weight data were collected following the intervention. One-way ANOVAs were used to analyze the data. Results indicated the treatment was effective at increasing the physical activity level of children, especially girls. No significant differences between groups were found for BMI. Programs such as PLAY, which can increase the activity level of children, may have significant health implications for youth. Physical inactivity and obesity are major public health problems. Our objective was to investigate the effectiveness of an individual counseling intervention at the workplace on physical activity fitness and health. Counseling content derived from the Patient-centered Assessment and Counseling for Exercise and Nutrition (PACE) program.
                A total of 299 employees of three municipal services in the Dutch town of Enschede were randomly allocated into intervention (n =131) and control group (n =168). Over a 9-month period, intervention group subjects were offered seven counseling sessions. Counseling was based on the individual's stage of behavioral change using PACE physical activity and nutrition protocols. Subjects in both the intervention and control group received written information about several lifestyle factors. Primary outcome measures were physical activity (total energy expenditure, during sports activities, during physical activity leisure time other than sports, and meeting the moderate-intensity public health recommendations); cardiorespiratory fitness; and prevalence of musculoskeletal symptoms. Secondary outcome measures were body composition (body mass index [BMI], and percentage of body fat measured via skinfold thicknesses); blood pressure; and blood cholesterol.
                There were significant positive effects on total energy expenditure, physical activity during sports, cardiorespiratory fitness, percentage of body fat, and blood cholesterol. No effects were found for the proportion of subjects meeting the public health recommendation of moderate-intensity physical activity, physical activity during leisure time other than sports, prevalence of musculoskeletal symptoms, body mass index, and blood pressure.
                Individual face-to-face counseling at the workplace based on PACE protocols positively influenced physical activity levels and some components of physical fitness. The implementation of workplace counseling programs for individuals should therefore be promoted. Currently there is a great deal of interest in multistrategy community-based approaches to changing physical activity or health behaviors. The aim of this article is to describe the effectiveness of the physical activity promotion project "10,000 Steps Ghent" after 1 year of intervention.
                A multistrategy community-based intervention was implemented in 2005 with follow-up measurements in 2006 to promote physical activity to adults. A local media campaign, environmental approaches, the sale and loan of pedometers, and several local physical activity projects were concurrently implemented. In 2005, 872 randomly selected subjects (aged 25 to 75), from the intervention community Ghent and 810 from a comparison community, participated in the baseline measurements. Of these, 660 intervention subjects and 634 comparison subjects completed the follow-up measurements in 2006. Statistical analyses were performed in 2006.
                After one year there was an increase of 8% in the number of people reaching the "10,000 steps" standard in Ghent, compared with no increase in the comparison community. Average daily steps increased by 896 (95% CI=599-1192) in the intervention community, but there was no increase in the comparison community (mean change -135 [95% CI= -432 to 162]) (F time x community=22.8, p<0.001). Results are supported by self-reported International Physical Activity Questionnaire (IPAQ) data.
                The "10,000 steps/day" message reached the Ghent population and the project succeeded in increasing pedometer-determined physical activity levels in Ghent, after 1 year of intervention. Several World Health Organisation reports over recent years have highlighted the high incidence of chronic diseases such as diabetes, coronary heart disease and cancer. Contributory factors include unhealthy diets, alcohol and tobacco use and sedentary lifestyles. This paper reports the findings of a review of reviews of behavioural change interventions to reduce unhealthy behaviours or promote healthy behaviours. We included six different health-related behaviours in the review: healthy eating, physical exercise, smoking, alcohol misuse, sexual risk taking (in young people) and illicit drug use. We excluded reviews which focussed on pharmacological treatments or those which required intensive treatments (e.g. for drug or alcohol dependency).
                The Cochrane Library, Database of Abstracts of Reviews of Effectiveness (DARE) and several Ovid databases were searched for systematic reviews of interventions for the six behaviours (updated search 2008). Two reviewers applied the inclusion criteria, extracted data and assessed the quality of the reviews. The results were discussed in a narrative synthesis.
                We included 103 reviews published between 1995 and 2008. The focus of interventions varied, but those targeting specific individuals were generally designed to change an existing behaviour (e.g. cigarette smoking, alcohol misuse), whilst those aimed at the general population or groups such as school children were designed to promote positive behaviours (e.g. healthy eating). Almost 50% (n = 48) of the reviews focussed on smoking (either prevention or cessation). Interventions that were most effective across a range of health behaviours included physician advice or individual counselling, and workplace- and school-based activities. Mass media campaigns and legislative interventions also showed small to moderate effects in changing health behaviours.Generally, the evidence related to short-term effects rather than sustained/longer-term impact and there was a relative lack of evidence on how best to address inequalities.
                Despite limitations of the review of reviews approach, it is encouraging that there are interventions that are effective in achieving behavioural change. Further emphasis in both primary studies and secondary analysis (e.g. systematic reviews) should be placed on assessing the differential effectiveness of interventions across different population subgroups to ensure that health inequalities are addressed. The objective of this study was to evaluate the impact of a school-based intervention (Program X) incorporating pedometers and e-mail support on physical activity, sedentary behavior, and healthy eating in adolescents.
                A randomized control trial was used to evaluate the impact of the Program X intervention. Six schools (N = 124 participants; mean age 14.1 +/- .8 years) were randomized to intervention or control conditions for the 6-month study period. Objectively recorded physical activity (mean steps/day), self-reported sedentary behavior, and dietary habits were measured at baseline and at 6-month follow-up and intervention effects were assessed using repeated-measures analysis of variance and chi(2) tests.
                Participants in the intervention group increased their step counts by 956 +/- 4107 steps/day (boys) and 999 +/- 1999 (girls). Repeated-measures analysis of variance revealed significant group-by-time interactions for boys (F = 7.4, p = .01, d = .80) and girls (F = 29.6, p <.001, d = 1.27) for mean steps/day. The intervention significantly decreased the number of energy-dense/low-nutrient snacks consumed by boys (chi(2) = 4.0, p = .043) and increased the number of fruit serves among girls (chi(2) = 4.8, p = .028). The intervention did not have a statistically significant effect on sedentary behavior.
                A school-based intervention incorporating physical activity monitoring using pedometers and e-mail support was successful in promoting physical activity and selected healthy eating behaviors in adolescent boys and girls. The purpose of the study was to compare the effects of three different types of group-based exercise programs (resistance training, agility training and general stretching) on back pain and health-related quality of life in older (aged 75-85 years) community-dwelling women with low bone mass (i.e., osteopenia or osteoporosis). The design was a 25-week randomized controlled trial. Participating were 98 community-dwelling women with low bone mass between the ages of 75 to 85 years old. We assessed back pain and its related disability and health-related quality of life. All three types of group-based exercise programs significantly reduced back pain and its related disabilities, but only resistance and agility training significantly improved health-related quality of life in community-dwelling older women with low bone mass. Baseline physical activity level and class attendance were significant predictors of change in health-related quality of life. Change in back pain and its related disabilities after 25 weeks of exercise intervention was significantly correlated with change in health-related quality of life and changes in the domains of pain and physical function. Resistance and agility training significantly enhanced health-related quality of life and may have done so by increasing social interactions and support, enhancing self-efficacy of physical abilities and modifying the experience of back pain. These data provide valuable insight into the specifics of exercise prescription for older women with low bone mass. Future studies may wish to use individualized quality of life measures to further delineate the effects of different types of exercise on quality of life in older adults with low bone mass. To evaluate the feasibility and efficacy of a workplace-based weight loss program (Workplace POWER-WP) for male shift workers.
                A prospective, two-armed randomized controlled trial of 110 overweight/obese (BMI 25-40) (mean [SD] age = 44.4 [8.6] years; BMI = 30.5 [3.6]) male employees at Tomago Aluminium aged 18-65. In October (2009) men were randomized to either (i) WP program (n=65) or (ii) a 14-week wait-list control group (n=45). The 3-month program involved one information session, program booklets, group-based financial incentives and an online component. Men were assessed at baseline and at 14-week follow-up for weight (primary outcome), waist circumference, BMI, blood pressure, resting heart rate, self-reported physical activity and dietary variables, and physical activity and dietary cognitions.
                Intention-to-treat analysis using linear mixed models revealed significant between group differences for weight loss after 14 weeks (P < .001, Cohen's d = 0.34). Significant intervention effects were also found for waist circumference (P < .001, d = 0.63), BMI (P < .001, d = 0.41), systolic blood pressure (P = .02, d = 0.48), resting heart rate (P < .001, d = 0.81), physical activity (P = .03, d = 0.77), sweetened beverages (P < .02, d = 0.5-0.6) and physical activity-related cognitions (P < .02, d=0.6).
                The WP program was feasible and efficacious and resulted in significant weight loss and improved health-related outcomes and behaviours in overweight male shift workers.
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There was limited and low quality data providing insufficient evidence to assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving subsequent health outcomes.