The 'Walking for Wellbeing in the West' randomised controlled trial of a pedometer-based walking programme in combination with physical activity consultation with 12 month follow-up: rationale and study design The effect of a pedometer-based community walking intervention "Walking for Wellbeing in the West" on physical activity levels and health outcomes: a 12-week randomized controlled trial Increasing older adults’ walking through primary care: results of a pilot randomized controlled trial Pedometers as a means to increase ambulatory activity for patients seen at a family medicine clinic. Effect of a 6-month pedometer-based walking intervention on functional capacity in patients with chronic heart failure with reduced (HFrEF) and with preserved (HFpEF) ejection fraction: study protocol for two multicenter randomized controlled trials The mPED randomized controlled clinical trial: applying mobile persuasive technologies to increase physical activity in sedentary women protocol A pilot randomized controlled trial evaluating motivationally matched pedometer feedback to increase physical activity behavior in older adults. Does physical activity counselling enhance the effects of a pedometer-based intervention over the long-term: 12-month findings from the Walking for Wellbeing in the west study Effectiveness of a Web-Based, Computer-Tailored, Pedometer-Based Physical Activity Intervention for Adults: A Cluster Randomized Controlled Trial Feasibility of pedometers for adults with schizophrenia: pilot study. Steps that count! : The development of a pedometer-based health promotion intervention in an employed, health insured South African population A randomized controlled trial of an automated exercise coach for older adults. Randomised controlled trial of a pedometer-based telephone intervention to increase physical activity among cardiac patients not attending cardiac rehabilitation. Pedometer walking plus motivational interviewing program for Thai schizophrenic patients with obesity or overweight: a 12-week, randomized, controlled trial. Long-Term Effects of an Internet-Mediated Pedometer-Based Walking Program for Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial A Web-Based Intervention to Encourage Walking (StepWise): Pilot Randomized Controlled Trial A population-based randomized controlled trial of the effect of combining a pedometer with an intervention toolkit on physical activity among individuals with low levels of physical activity or fitness.
Background Scotl and has a policy aim ed at increasing physical activity levels in the population , but evidence on how to achieve this is still developing . Studies that focus on encouraging real world participants to start physical activity in their setting s are needed . The Walking for Well-being in the West study was design ed to assess the effectiveness of a pedometer-based walking programme in combination with physical activity consultation . The study was multi-disciplinary and based in the community . Walking for Well-being in the West investigated whether Scottish men and women , who were not achieving the current physical activity recommendation , increased and maintained walking behaviour over a 12 month period . This paper outlines the rationale and design of this innovative and pragmatic study . Methods Participants were r and omised into two groups : Group 1 : Intervention ( pedometer-based walking programme combined with a series of physical activity consultations ) ; Group 2 : Waiting list control for 12 weeks ( followed by minimal pedometer-based intervention ) . Physical activity ( primary outcome ) was measured using  pedometer step counts ( 7 day ) and the International Physical Activity Question naire ( long version ) . Psychological processes were measured using question naires relating to the Transtheoretical Model of Behaviour Change , mood ( Positive and Negative Affect Schedule ) and quality of life ( Euroqol EQ-5D instrument ) . Physiological measures included anthropometric and metabolic outcomes . Environmental influences were assessed subjectively ( Neighbourhood Quality of Life Survey ) and objective ly ( neighbourhood audit tool and GIS mapping ) . The qualitative evaluation employed observation , semi-structured interviews and focus groups . A supplementary study undertook an economic evaluation . Discussion Data analysis is on-going . Walking for Well-being in the West will demonstrate if a pedometer based walking programme , in combination with physical activity consultation results in a sustainable increase in walking behaviour in this sample of Scottish adults over a 12 month period . The study will examine the complex relationships between behavioural change , health consequences and the role of the environment , in conjunction with the cost effectiveness of this approach and a detailed insight into the participants ' experiences of the intervention . Trial registration Current Controlled Trials IS RCT Background Recent systematic review s have suggested that pedometers may be effective motivational tools to promote walking . However , studies tend to be of a relatively short duration , with small clinical based sample s. Further research is required to demonstrate their effectiveness in adequately powered , community based studies . Objective Using a r and omized controlled trial design , this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts , self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations . MethodS ixty-three women and 16 men ( 49.2 years ± 8.8 ) were r and omly assigned to either an intervention ( physical activity consultation and 12-week pedometer-based walking program ) or control ( no action ) group . Measures for step-counts , 7-day physical activity recall , affect , quality of life ( n = 79 ) , body mass , BMI , % body fat , waist and hip circumference ( n = 76 ) , systolic/diastolic blood pressure , total cholesterol and HDL cholesterol ( n = 66 ) were taken at baseline and week 12 . Analyses were performed on an intention to treat basis using 2-way mixed factorial analyses of variance for parametric data and Mann Whitney and Wilcoxon tests for non-parametric data . Results Significant increases were found in the intervention group for step-counts ( p < .001 ) , time spent in leisure walking ( p = .02 ) and positive affect ( p = .027 ) . Significant decreases were found in this group for time spent in weekday ( p = .003 ) , weekend ( p = .001 ) and total sitting ( p = .001 ) with no corresponding changes in the control group . No significant changes in any other health outcomes were found in either group . In comparison with the control group at week 12 , the intervention group reported a significantly greater number of minutes spent in leisure time ( p = .008 ) , occupational ( p = .045 ) and total walking ( p = .03 ) , and significantly fewer minutes in time spent in weekend ( p = .003 ) and total sitting ( p = .022 ) . Conclusion A pedometer-based walking program , incorporating a physical activity consultation , is effective in promoting walking and improving positive affect over 12 weeks in community based individuals . The discussion examines possible explanations for the lack of significant changes in health outcomes . Continued follow-up of this study will examine adherence to the intervention and possible result ing effects on health outcomes Background . Physical activity can positively influence health for older adults . Primary care is a good setting for physical activity promotion . Objective . To assess the feasibility of a pedometer-based walking programme in combination with physical activity consultations . Methods . Design : Two-arm ( intervention/control ) 12-week r and omized controlled trial with a 12-week follow-up for the intervention group . Setting : One general practice in Glasgow , UK . Participants : Participants were aged ≥65 years . The intervention group received two 30-minute physical activity consultations from a trained practice nurse , a pedometer and a walking programme . The control group continued as normal for 12 weeks and then received the intervention . Both groups were followed up at 12 and 24 weeks . Outcome measures : Step counts were measured by sealed pedometers and an activPALTM monitor . Psychosocial variables were assessed and focus groups conducted . Results . The response rate was 66 % ( 187/284 ) , and 90 % of those r and omized ( 37/41 ) completed the study . Qualitative data suggested that the pedometer and nurse were helpful to the intervention . Step counts ( activPAL ) showed a significant increase from baseline to week 12 for the intervention group , while the control group showed no change . Between weeks 12 and 24 , step counts were maintained in the intervention group , and increased for the control group after receiving the intervention . The intervention was associated with improved quality of life and reduced sedentary time . Conclusions . It is feasible to recruit and retain older adults from primary care and help them increase walking . A larger trial is necessary to confirm findings and consider cost-effectiveness Because of their frequent encounters with sedentary patients , family physicians are poised to be on the forefront of the medical community 's response to physical inactivity . The purpose of this pilot study was to examine whether the addition of a pedometer to brief physician counseling could help patients increase their ambulatory activity .  Ninety four participants recruited from a family medicine clinic were r and omly assigned to 2 groups . Both groups received a brief physician endorsement of regular physical activity , a h and out on the benefits of an active lifestyle , and 3 follow-up phone calls from a health educator . In addition , the intervention group received a pedometer and was instructed to record their steps daily over the 9-week study period . Measurements were taken for self-reported walking , walking stage-of-change , walking self-efficacy , and pedometer steps ( intervention group only ) . Among completers , mean daily step counts in the pedometer group rose from 6779 at baseline to 8855 at study end . Average individual improvement was 41 % over the study period . Both groups significantly increased blocks walked per day , stair climbing versus using the elevator , days per week walking > or = 30 minutes , and walking for fun/leisure . The frequency of walking short trips improved significantly more in the pedometer group relative to the comparison group . The results of this pilot study highlight the need for further research on the use of pedometers as a motivational tool in the context of medical encounters with inactive patients Abstract Background Regular physical activity is recommended for patients with chronic heart failure to improve their functional capacity , and walking is a popular , effective , and safe form of physical activity . Pedometers have shown potential to increase the amount of walking across a range of chronic diseases , but it is unknown whether a pedometer-based intervention improves functional capacity and neurohumoral modulation in heart failure patients . Methods Two multicenter r and omized controlled trials will be conducted in parallel : one in patients with chronic heart failure with reduced ejection fraction ( HFrEF ) , the other in patients with chronic heart failure with preserved ejection fraction ( HFpEF ) . Each trial will consist of a 6-month intervention with an assessment at baseline , at 3 months , at the end of the intervention , and 6 months after completing the intervention . Each trial will aim to include a total of 200 physically inactive participants with chronic heart failure who will be r and omly assigned to intervention or control arms . The 6-month intervention will consist of an individualized pedometer-based walking program with weekly step goals , behavioral face-to-face sessions with a physician , and regular telephone calls with a research nurse . The intervention will be based on effective behavioral principles ( goal setting , self-monitoring , personalized feedback ) . The primary outcome is the change in 6-min walk distance at the end of the 6-month intervention . Secondary outcomes include changes in serum biomarkers levels , pulmonary congestion assessed by ultrasound , average daily step count measured by accelerometry , anthropometric measures , symptoms of depression , health-related quality of life , self-efficacy , and MAGGIC risk score . Discussion To our knowledge , these are the first studies to evaluate a pedometer-based walking intervention in patients with chronic heart failure with either reduced or preserved ejection fraction . The studies will contribute to a better underst and ing of physical activity promotion in heart failure patients to inform future physical activity recommendations and heart failure guidelines . Trial registration The trials are registered in Clinical Trials.gov , identifiers : NCT03041610 , registered 29 January 2017 ( HFrEF ) , NCT03041376 , registered 1 February 2017 ( HFpEF Background Despite the significant health benefits of regular physical activity , approximately half of American adults , particularly women and minorities , do not meet the current physical activity recommendations . Mobile phone technologies are readily available , easily accessible and may provide a potentially powerful tool for delivering physical activity interventions . However , we need to underst and how to effectively apply these mobile technologies to increase and maintain physical activity in physically inactive women . The purpose of this paper is to describe the study design and protocol of the mPED ( mobile phone based physical activity education ) r and omized controlled clinical trial that examines the efficacy of a 3-month mobile phone and pedometer based physical activity intervention and compares two different 6-month maintenance interventions . Methods A r and omized controlled trial ( RCT ) with three arms ; 1 ) PLUS ( 3-month mobile phone and pedometer based physical activity intervention and 6-month mobile phone diary maintenance intervention ) , 2 ) REGULAR ( 3-month mobile phone and pedometer based physical activity intervention and 6-month pedometer maintenance intervention ) , and 3 ) CONTROL ( pedometer only , but no intervention will be conducted ) . A total of 192 physically inactive women who meet all inclusion criteria and successfully complete a 3-week run-in will be r and omized into one of the three groups . The mobile phone serves as a means of delivering the physical activity intervention , setting individualized weekly physical activity goals , and providing self-monitoring ( activity diary ) , immediate feedback and social support . The mobile phone also functions as a tool for communication and real-time data capture . The primary outcome is objective ly measured physical activity . Discussion If efficacy of the intervention with a mobile phone is demonstrated , the results of this RCT will be able to provide new insights for current behavioral sciences and mHealth . Trial Registration Clinical BACKGROUND Increasing physical activity ( PA ) levels in older adults represents an important public health challenge . The purpose of this study was to evaluate the feasibility of combining individualized motivational messaging with pedometer walking step targets to increase PA in previously inactive and insufficiently active older adults . METHODS In this 12-week intervention study older adults were r and omized to 1 of 4 study arms : Group 1 - -control ; Group 2 - -pedometer 10,000 step goal ; Group 3 - -pedometer step goal plus individualized motivational feedback ; or Group 4 - -everything in Group 3 augmented with biweekly telephone feedback . RESULTS 81 participants were r and omized into the study , 61 participants completed the study with an average age of 63.8 ± 6.0 years . Group 1 did not differ in accumulated steps/day following the 12-week intervention compared with participants in Group 2 . Participants in Groups 3 and 4 took on average 2159 ( P < .001 ) and 2488 ( P < .001 ) more steps/day , respectively , than those in Group 1 after the 12-week intervention . CONCLUSION In this 12-week pilot r and omized control trial , a pedometer feedback intervention partnered with individually matched motivational messaging was an effective intervention strategy to significantly increase PA behavior in previously inactive and insufficiently active older adults Background Pedometers provide a simple , cost effective means of motivating individuals to increase walking yet few studies have considered if short term changes in walking behaviour can be maintained in the long-term . The role of physical activity consultations in such interventions is unclear . The purpose of this study was to assess the sustainability of pedometer-based interventions and empirically examine the role of physical activity consultations using long-term results of a community-based walking study . Methods 79 low active Scottish men and women ( 63 women and 16 men ) from the Walking for Wellbeing in the West intervention study were r and omly assigned to receive either : Group 1 ; pedometer-based walking programme plus physical activity consultations or Group 2 ; pedometer-based walking programme and minimal advice .  Step counts ( Omron HJ-109E Step-O-Meter pedometer ) , 7 day recall of physical activity ( IPAQ long ) , mood ( PANAS ) and quality of life ( EuroQol EQ-5D ) were assessed pre-intervention and 12 , 24 and 48 weeks after receiving the intervention . Body mass , body mass index and waist and hip circumference were assessed pre-intervention and 12 and 24 weeks after receiving the intervention . Analyses were performed on an intention to treat basis ( baseline value carried forward for missing data ) using mixed-factorial ANOVAs and follow-up t-tests . Results A significant main effect of time ( p < 0.001 ) was found for step-counts attributable to significant increases in steps/day between : pre-intervention ( M = 6941 , SD = 3047 ) and 12 weeks ( M = 9327 , SD = 4136 ) , t(78 ) = - 6.52 , p < 0.001 , d = 0.66 ; pre-intervention and 24 weeks ( M = 8804 , SD = 4145 ) , t(78 ) = - 4.82 , p < 0.001 , d = 0.52 ; and pre-intervention and 48 weeks ( M = 8450 , SD = 3855 ) , t(78 ) = - 4.15 , p < 0.001 , d = 0.44 . Significant effects were found for several variables of self-reported physical activity , mood and quality of life and are discussed . No other significant effects in health related outcomes were found . Conclusion Both interventions successfully increased and maintained step counts over 12 months . Physical activity consultations may encourage individuals to be active in other ways beyond walking and to reduce sitting time . Trial Registration NumberCurrent Controlled Trials Ltd IS RCT Background Computer-tailored physical activity ( PA ) interventions delivered through the Internet represent a promising and appealing method to promote PA at a population level . However , personalized advice is mostly provided based on subjectively measured PA , which is not very accurate and might result in the delivery of advice that is not credible or effective . Therefore , an innovative computer-tailored PA advice was developed , based on objective ly pedometer-measured PA . Objective The study aim was to evaluate the effectiveness of a computer-tailored , pedometer-based PA intervention in working adults . Methods Participants ( ≥18 years ) were recruited between May and December 2012 from eight Flemish workplaces . These workplaces were allocated r and omly to an intervention or control group . Intervention group participants ( n=137 ) received ( 1 ) a booklet with information on how to increase their steps , ( 2 ) a non-blinded pedometer , and ( 3 ) an Internet link to request computer-tailored step advice . Control group participants ( n=137 ) did not receive any of the intervention components . Self-reported and pedometer-based PA  were assessed at baseline ( T0 ) , and 1 month ( T1 ) and 3 months ( T2 ) months post baseline . Repeated measures analyses of covariance were used to examine intervention effects for both the total sample and the at-risk sample ( ie , adults not reaching 10,000 steps a day at baseline ) . Results The recruitment process result ed in 274 respondents ( response rate of 15.1 % ) who agreed to participate , of whom 190 ( 69.3 % ) belonged to the at-risk sample . Between T0 and T1 ( 1-month post baseline ) , significant intervention effects were found for participants ’ daily step counts in both the total sample ( P=.004 ) and the at-risk sample ( P=.001 ) . In the at-risk sample , the intervention effects showed a daily step count increase of 1056 steps in the intervention group , compared to a decrease of 258 steps in the control group . Comparison of participants ’ self-reported PA revealed a significant intervention effect for time spent walking in the at-risk sample ( P=.02 ) . Intervention effects were still significant 3 months post baseline for participants ’ daily step counts in both the total sample ( P=.03 ) and the at-risk sample ( P=.02 ) ; however , self-reported PA differences were no longer significant . Conclusions A computer-tailored , pedometer-based PA intervention was effective in increasing both pedometer-based and self-reported PA levels , mainly in the at-risk participants . However , more effort should be devoted to recruit and retain participants in order to improve the public health impact of the intervention . Trial Registration Clinical Trials.gov : NCT02080585 ; https:// clinical trials.gov/ct2/show/NCT02080585 ( Archived by WebCite at http://www.webcitation.org/6VvQnRQSy ) The purpose of this prospect i ve and observational design study was to assess the feasibility of using a pedometer and step log to explore  level of physical activity ( PA )  and to assess motivation to be physically active in adults with schizophrenia . Descriptive statistics were used to analyse data of 7 male and 5 female subjects . Pedometer data indicated that subjects walked an average of 4731.03 ( ±3318.19 ) steps and 5002.58 ( ±3041.03 ) during the first week and second week of the study , respectively . A minimum 30-min walk was recorded on an average of 3.67 ( ±1.82 ) days ( week one ) and 4.5 ( ±1.88 ) days ( week two ) . Step logs , inconsistently maintained by subjects , were not able to be analysed . Examination of the Motives for Physical Activity Measure-Revised ( MPAM-R ) at baseline indicates that exercise fitness and body appearance were subjects ' primary motives for PA participation . Study findings indicate that it is feasible to use a pedometer to monitor the level of PA  . However , maintenance of a concurrent step log requires further consideration to determine realistic outcomes . Extrinsically focused motivations for PA in this study sample may predict low PA adherence Background  Physical activity ( PA )  has been identified as a central component in the promotion of health . PA programs can provide a low cost intervention opportunity , encouraging PA behavioral change while worksites have been shown to be an appropriate setting for implementing such health promotion programs . Along with these trends , there has been an emergence of the use of pedometers as a self-monitoring and motivational aid for PA.This study determines the effectiveness of a worksite health promotion program comprising of a 10-week , pedometer-based intervention ( “ Steps that Count ! ” ) , and individualized email-based feedback to effect PA behavioral change . Methods The study is a r and omized controlled trial in a worksite setting , using pedometers and individualized email-based feedback to increase steps per day ( steps/d ) .  Participant selection will be based on attendance at a corporate wellness event and information obtained , following the completion of a Health Risk Appraisal ( HRA ) , in keeping with inclusion criteria for the study . All participants will , at week 1 ( pre-intervention ) , be provided with a blinded pedometer to assess baseline levels of PA . Participants will be provided with feedback on pedometer data and identify strategies to improve daily PA towards current PA recommendations . Participants will thereafter be r and omly assigned to the intervention group ( INT ) or control group ( CTL ) . The INT will subsequently wear an un-blinded pedometer for 10 consecutive weeks . Individualized feedback messages based on average steps per day , derived from pedometer data ( INT ) and general supportive/motivational messages ( INT+CTL ) , will be provided via bi-weekly e-mails ; blinded pedometer-wear will be conducted at week 12 ( post-intervention : INT+CTL ) . Discussion The purpose of this paper is to outline the rationale behind , and the development of , an intervention aim ed at improving ambulatory PA through pedometer use , combined with regular , individualized , email-based feedback . Pedometer-measured PA and individualized feedback may be a practical and easily applied intervention . Trial registration Number : DOH-27 - 0112 - OBJECTIVES To compare the efficacy of a computer-based physical activity program ( Embodied Conversational Agent-ECA ) with that of a pedometer control condition in sedentary older adults . DESIGN Single-blind block-r and omized controlled trial stratified according to clinic site and health literacy status . SETTING Three urban ambulatory care practice s at Boston Medical Center between April 2009 and September 2011 . PARTICIPANTS Older adults ( N = 263 ; mean age 71.3 ; 61 % female ; 63 % African American ; 51 % high school diploma or less ) . INTERVENTION  ECA participants were provided with portable tablet computers with touch screens to use for 2 months and were directed to connect their pedometers to the computer using a data cable and interact with a computer-animated virtual exercise coach daily to discuss walking and to set walking goals . Intervention participants were then given the opportunity to interact with the ECA in a kiosk in their clinic waiting room for the following 10 months . Control participants were given a control pedometer intervention that only tracked step counts for an equivalent period of time . Intervention participants were also provided with pedometers . MEASUREMENTS The primary outcome was average daily step count for the 30 days before the 12-month interview . Secondary outcomes were average daily step count for the 30 days before the 2-month interview . Outcomes were also stratified according to health literacy level . RESULTS ECA participants walked significantly more steps than control participants at 2 months ( adjusted mean 4,041 vs 3,499 steps/day , P = .01 ) , but this effect waned by 12 months ( 3,861 vs 3,383 , P = .09 ) . For participants with adequate health literacy , those in the ECA group walked significantly more than controls at both 2 months ( P = .03 ) and 12 months ( P = .02 ) , while those with inadequate health literacy failed to show significant differences between treatment groups at either time point . Intervention participants were highly satisfied with the program . CONCLUSION An automated exercise promotion system deployed from outpatient clinics increased walking among older adults over the short-term . Effective methods for long-term maintenance of behavior change are needed OBJECTIVE To determine the effectiveness of a pedometer-based telephone intervention on the physical activity levels of cardiac patients who did not attend a CRP . METHODS A r and omised controlled trial was conducted with 215 patients referred to a CRP but who could not or chose not to attend . The 6-week intervention included self-monitoring of physical activity using a pedometer and step calendar ; and behavioural counselling and goal setting sessions . Data were collected at baseline , 6 weeks and 6 months . RESULTS Study groups did not differ significantly at baseline . After 6 weeks , improvements in total physical activity time ( p=0.027 ) , total physical activity sessions ( p=0.003 ) , walking time ( p=0.013 ) and walking sessions ( p=0.002 ) in the intervention group were significantly greater than the control group after adjusting for baseline differences , and remained significant at 6 months . CONCLUSION The findings that the pedometer-based telephone intervention was successful in increasing physical activity levels in cardiac patients who did not attend a CRP could result in major health benefits for this group of people . PRACTICAL IMPLICATION S The pedometer-based telephone intervention could be offered as an effective and accessible option for patients not attending a CRP to increase and maintain their physical activity levels after hospitalisation AIM The aim of this study was to design and examine a program called the ' pedometer walking plus motivational interviewing ( PWMI ) program ' in schizophrenic patients who are obese or overweight . METHODS This was a 12-week , r and omized , parallel , open-label , controlled trial in mildly ill schizophrenic patients with a body mass index ( BMI ) of 23.0 kg/m(2 ) or more . Each participant in the intervention or control group was given a leaflet entitled ' What is a healthy lifestyle ? ' The 1-week , PWMI program consisted of five 1-h sessions of individual motivational interviewing , group education , goal - setting , and practising of pedometer walking . The pedometers were given to the intervention group only . Weight , height , BMI and waist circumference were assessed at baseline , week 4 , week 8 , and week 12 . The primary outcome of this trial was the changed bodyweight at week 4 , week 8 , and week 12 . RESULTS Of 64 participants , 32 each were r and omly allocated to intervention and control groups . All participants completed the study . Only the means of changed bodyweight at week 12 were significantly different between groups ( P = 0.03 ) . At this week , the bodyweight of the intervention group decreased significantly more than that of the control group with a mean difference of 2.21 kg ( 95 % confidence interval of 4.12 - 0.29 ) . CONCLUSION Increased physical activity by pedometer walking plus individual motivational interviewing may be an effective program for the reduction of bodyweight and BMI  in Thai schizophrenic patients who are obese or overweight . Its efficacy may be comparable to other cognitive/behavioral programs . Further studies in larger sample sizes are warranted Background Regular physical activity ( PA ) is recommended for persons with chronic obstructive pulmonary disease ( COPD ) . Interventions that promote PA and sustain long-term adherence to PA are needed . Objective We examined the effects of an Internet-mediated , pedometer-based walking intervention , called Taking Healthy Steps , at 12 months . Methods Veterans with COPD ( N=239 ) were r and omized in a 2:1 ratio to the  intervention  or wait-list control . During the first 4 months , participants in the intervention group were instructed to wear the pedometer every day , upload daily step counts at least once a week , and were provided access to a website with four key components : individualized goal setting , iterative feedback , educational and motivational content , and an online community forum . The subsequent 8-month maintenance phase was the same except that participants no longer received new educational content . Participants r and omized to the wait-list control group were instructed to wear the pedometer , but they did not receive step-count goals or instructions to increase PA . The primary outcome was health-related quality of life ( HRQL ) assessed by the St George ’s Respiratory Question naire Total Score ( SGRQ-TS ) ; the secondary outcome was daily step count . Linear mixed-effect models assessed the effect of intervention over time . One participant was excluded from the analysis because he was an outlier . Within the intervention group , we assessed pedometer adherence and website engagement by examining percent of days with valid step-count data , number of log-ins to the website each month , use of the online community forum , and responses to a structured survey . Results Participants were 93.7 % male ( 223/238 ) with a mean age of 67 ( SD 9 ) years . At 12 months , there were no significant between-group differences in SGRQ-TS or daily step count . Between-group difference in daily step count was maximal and statistically significant at month 4 ( P<.001 ) , but approached zero in months 8 - 12 . Within the intervention group , mean 76.7 % ( SD 29.5 ) of 366 days had valid step-count data , which decreased over the months of study ( P<.001 ) . Mean number of log-ins to the website each month also significantly decreased over the months of study ( P<.001 ) . The online community forum was used at least once during the study by 83.8 % ( 129/154 ) of participants . Responses to questions assessing participants ’ goal commitment and intervention engagement were not significantly different at 12 months compared to 4 months . Conclusions An Internet-mediated , pedometer-based PA intervention , although efficacious at 4 months , does not maintain improvements in HRQL and daily step counts at 12 months . Waning pedometer adherence and website engagement by the intervention group were observed . Future efforts should focus on improving features of PA interventions to promote long-term behavior change and sustain engagement in PA . Clinical Trial Clinical trials.gov NCT01102777 ; https:// clinical trials.gov/ct2/show/NCT01102777 ( Archived by WebCite at http://www.webcitation.org/6iyNP9KUC Background Despite Internet-based interventions that incorporate pedometers with appropriate goal - setting processes and other theoretically-based behavior change strategies being proposed as a means of increasing walking behavior , few have incorporated all of these key features or assessed maintenance of behavior change . Objective The objective of our study was to investigate the effect of a 12-week pedometer step goal walking program individually tailored to baseline step counts , combined with an interactive support website for step counts , health parameters and motivation over 12 and 24 weeks . Methods Low active participants ( mean [ SD ] 46.2 [ 11.2 ] years ) were r and omly assigned to the  Stepwise ( SW ) intervention group ( n=49 ) or a  comparison ( CP ) group ( n=48 ) . SW received a pedometer , step goal walking program and access to the SW website ( containing interactive self-monitoring and goal feedback tools , motivational messages and action and coping planning strategies ) . CP received a pedometer and locally available physical activity information . Step counts , BMI , resting heart rate , blood pressure and glucose , cholesterol and triglyceride levels , psychological well-being , perceived health , self-efficacy and self-determined motivation were measured at baseline , 12 and 24 weeks . Results Linear mixed model analysis found that both groups ’ step counts increased from baseline to week 12 ( β = 11,002 , CI 5739 - 16,266 , P<.001 ) and 24 ( β = 6810 , CI 1190 - 12,431 ; P=.02 ) . Group step counts were significantly different at week 24 with SW taking 8939 ( CI 274 - 17604 , P=.04 ) more steps compared to CP . Compared to baseline , both groups had improved triglyceride levels ( 0.14 mmol/L , CI -0.25 to -0.02 , P=.02 ) at week 12 , decreased diastolic blood pressure ( 4.22 mmHg , CI -6.73 to -1.72 ) at weeks 12 and 24 ( 3.17 mmHg , CI -5.55 to -0.78 ) , improved positive ( β = .21 , CI 0.03 - 0.38 , P=.02 ) and negative affect ( β = -.15 , CI -0.28 to -0.03 , P=.02 ) at week 12 , and perceived health at week 12 ( β = 6.37 , CI 2.10 - 10.65 , P=.004 ) and 24 ( β = 8.52 , CI 3.98 - 13.06 , P<.001 ) . Total cholesterol increased at week 12 ( 0.26 mmol/L , CI 0.099 - 0.423 , P=.006 ) and week 24 ( 0.38 mmol/L , CI 0.20 - 0.56 , P<.001 ) . Repeated measures ANOVA found motivation for walking improved from baseline with higher task self-efficacy ( P<.001 , η2 = .13 ) and autonomous motivation ( P<.001 , η2=.14 ) at weeks 12 and 24 and decreased controlled motivation ( P=.004 , η2=.08 ) at week 24 . Conclusions Both groups had similar improvements in step counts and physical and psychological health after 12 weeks but only the SW group successfully maintained the increased step-counts 24 weeks post-intervention . This suggests the step- goal based walking program combined with Internet-based behavior change tools were important for sustained behavior change OBJECTIVES To examine if receiving a pedometer along with an intervention toolkit is associated with increased physical activity , aerobic fitness and better self-rated health among individuals with low levels of physical activity or fitness . METHODS The intervention was nested in the Danish Health Examination Survey ( DANHES ) and carried out in 2008 . Participants were r and omly assigned to either a pedometer group ( n=326 ) or a control group ( n=329 ) . Physical activity , aerobic fitness , and self-rated health were measured at baseline and at 3-month follow-up , and differences were tested by Wilcoxons signed rank tests and Chi-squared tests . RESULTS At follow-up , no significant differences in physical activity , aerobic fitness and self-rated health were found between the groups . However , the oldest participants in the pedometer group reported significantly more walking time compared to the controls ( controls=368 min/week , pedometer group=680 min/week , P=0.05 ) . Among participants who completed the intervention , a significant effect on total walking time was observed ( median difference=225 min/week , P=0.04 ) . CONCLUSIONS The results suggest that receiving a pedometer and along with an intervention toolkit can increase walking time in older individuals , but not in younger individuals . Thus , this type of intervention offers great potential for promoting physical activity in older individuals . TRIAL REGISTRATION NUMBER NCT01071811
No significant changes in any other health outcomes were found in either group .
Background : Recent systematic review s have suggested that pedometers may be effective motivational tools to promote walking .
However , studies tend to be of a relatively short duration , with small clinical based sample s. Further research is required to demonstrate their effectiveness in adequately powered , community based studies .
Objective : Using a r and omized controlled trial design , this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts , self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations .