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 Promoting walking with pedometers in the community: the step-by-step trial. 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 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 The feasibility of using pedometers and brief advice to increase activity in sedentary older women – a pilot study A home-based pedometer-driven walking program to increase physical activity in older adults with osteoarthritis of the knee: a preliminary study. Pedometers as a means to increase ambulatory activity for patients seen at a family medicine clinic. Promoting physical activity in COPD: Insights from a randomized trial of a web-based intervention and pedometer use. Taking Healthy Steps: rationale, design and baseline characteristics of a randomized trial of a pedometer-based internet-mediated walking program in veterans with chronic obstructive pulmonary disease Correlates of pedometer use: Results from a community-based physical activity intervention trial (10,000 Steps Rockhampton) West End Walkers 65+: A randomised controlled trial of a primary care-based walking intervention for older adults: Study rationale and design The effect of an intervention combining self-efficacy theory and pedometers on promoting physical activity among adolescents. Pedometers and Text Messaging to Increase Physical Activity A Web-Based Intervention to Encourage Walking (StepWise): Pilot Randomized Controlled Trial Effectiveness of a Web-Based, Computer-Tailored, Pedometer-Based Physical Activity Intervention for Adults: A Cluster Randomized Controlled Trial Short-Term Effects of Using Pedometers to Increase Daily Physical Activity in Smokers: A Randomized Trial The mPED randomized controlled clinical trial: applying mobile persuasive technologies to increase physical activity in sedentary women protocol Investigating the effect of a 3-month workplace-based pedometer-driven walking programme on health-related quality of life in meat processing workers: a feasibility study within a randomized controlled trial Long-Term Effects of an Internet-Mediated Pedometer-Based Walking Program for Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial A randomized controlled trial of an automated exercise coach for older adults. Increasing older adults’ walking through primary care: results of a pilot randomized controlled trial Pilot Study of a Faith-Based Physical Activity Program Among Sedentary Blacks Steps that count! : The development of a pedometer-based health promotion intervention in an employed, health insured South African population The effect of pedometer use in combination with cognitive and behavioral support materials to promote physical activity. Effectiveness of a Walking Group Intervention to Promote Physical Activity and Cardiovascular Health in Predominantly Non-Hispanic Black and Hispanic Urban Neighborhoods Sociodemographic determinants of pedometer-determined physical activity among Japanese adults.
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 Pedometers have been identified as a potential motivational aid for increasing physical activity , but their efficacy has not been demonstrated in a community-based , non clinical sample . DESIGN A r and omized controlled trial was conducted from August to December 2005 . Analysis was completed in June 2006 . SETTING / PARTICIPANTS Inactive adults aged 30 - 65 years ( n=369 ) recruited from the community . INTERVENTION Comparison of a theoretically based self-help walking program ( WP ) and weekly diaries ( sent by mail ) ; the same walking program with a pedometer ( WPP ) ( also by mail ) ; and a no-treatment control group ( C ) . MEASURES Change in self-reported leisure time in any sports/recreation in the last 3 months , and all- purpose walking ( APW ) for exercise , recreation , and travel , and other moderate , vigorous physical activity in the last week . Proportions meeting physical activity recommendations ( equal to or greater than 150 minutes and equal to or greater than five sessions/week(-1 ) ) were determined . RESULTS A 3-month follow-up interview was conducted with 314 ( 85 % ) participants . Intention-to-treat analyses indicated significance within-group increases of APW and leisure-time walking ( LTW ) , but mean and median sessions and minutes changes were greatest in the WPP group . There were no significant between-group differences in regular LTW ( walked equal to or greater than 5 sessions/week(-1 ) for at least 30 minutes/session ) , but the WPP group increased significantly participation in other sports/recreations and was more likely than the control group to meet physical activity recommendations by all leisure-time physical activity ( adjusted odds ratio=2.40 , 95 % CI=1.17 - 4.93 ) , by APW ( adjusted odds ratio=1.75 95 % CI=0.92 - 3.34 ) and all physical activity ( adjusted odds ratio=1.59 95 % CI=0.92 - 2.79 ) in the last week . CONCLUSIONS Pedometers enhanced the effects of the self-help walking program . This low-cost intervention should be tested for sustainability 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 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 People over the age of 70 carry the greatest burden of chronic disease , disability and health care use . Participation in physical activity is crucial for health , and walking accounts for much of the physical activity undertaken by sedentary individuals . Pedometers are a useful motivational tool to encourage increased walking and they are cheap and easy to use . The aim of this pilot study was to evaluate the feasibility of the use of pedometers plus a theory-based intervention to assist sedentary older women to accumulate increasing amounts of physical activity , mainly through walking . Methods Female participants over the age of 70 were recruited from primary care and r and omised to receive either pedometer plus a theory-based intervention or a theory-based intervention alone . The theory-based intervention consisted of motivational techniques , goal - setting , barrier identification and self-monitoring with pedometers and daily diaries . The pedometer group were further r and omised to one of three target groups : a 10 % , 15 % or 20 % monthly increase in step count to assess the achievability and acceptability of a range of targets . The primary outcome was change in daily activity levels measured by accelerometry . Secondary outcome measures were lower limb function , health related quality of life , anxiety and depression . Results 54 participants were recruited into the study , with an average age of 76 . There were 9 drop outs , 45 completing the study . All participants in the pedometer group found the pedometers easy to use and there was good compliance with diary keeping ( 96 % in the pedometer group and 83 % in the theory-based intervention alone group ) . There was a strong correlation ( 0.78 ) between accelerometry and pedometer step counts i.e. indicating that walking was the main physical activity amongst participants . There was a greater increase in activity ( accelerometry ) amongst those in the 20 % target pedometer group compared to the other groups , although not reaching statistical significance ( p = 0.192 ) . Conclusion We have demonstrated that it is feasible to use pedometers and provide theory-based advice to community dwelling sedentary older women to increase physical activity levels and a larger study is planned to investigate this further OBJECTIVES To determine whether a home-based pedometer-driven walking program with arthritis self-management education ( Walk + ) would increase physical activity , muscle strength , and functional performance in older adults with osteoarthritis ( OA ) of the knee as opposed to arthritis self-management education alone ( EDU ) . DESIGN A r and omized two-by-three ( group-by-time ) design with participants assigned to  Walk + ( n = 17 , mean age + /- st and ard deviation = 69.6 + /- 6.7 ) or EDU ( n = 17 , age = 70.8 + /- 4.7 ) . SETTING Community located in the Baltimore-Washington area . PARTICIPANTS Thirty-four community-dwelling adults , aged 60 and older with symptomatic knee OA and self-reported functional impairment . INTERVENTIONS Both groups received 12 hours of the Arthritis Self-Management program over 12 weeks and were followed for an additional 12 weeks . In addition , the Walk + group received individualized instruction in the use of a pedometer , with the goal of increasing their step count by 30 % of their baseline step count . MEASUREMENTS The outcome measures were physical activity ( daily step counts and total activity vector magnitude as measured by a pedometer and Tritrac-R3D accelerometer ) , quadriceps femoris strength ( isometric peak torque ) , and functional performance tasks ( 100-foot walk-turn-walk , timed stair climb , timed chair rise , and pain status ) . RESULTS Daily steps walked showed a significant group-by-time interaction ( P = .04 ) after controlling for age . From baseline to completion of training , a 23 % increase in daily steps occurred in the Walk + group and a 15 % decrease in the EDU group . Although steps increased in the Walk + group , total activity vector magnitude was maintained , suggesting a more efficient gait . The Walk + group became quicker than the EDU group in the normal-pace walk-turn-walk ( P = .04 ) . An isometric strength gain of 21 % postintervention was seen in the Walk + group , compared with a loss of 3.5 % in the EDU group . CONCLUSION In older adults with symptomatic knee OA , Walk + appears to increase walking , with improvements in muscle strength and walking performance . The use of a home-based pedometer-driven program to increase physical activity , strength , and function in this population warrants further research 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 RATIONALE Low physical activity is highly prevalent among COPD patients and is associated with increased healthcare utilization and mortality and reduced HRQL . The addition of a website to pedometer use is effective at increasing physical activity ; however , the timeline of change and impact of environmental factors on efficacy is unknown . METHODS U.S. Veterans with COPD were r and omized ( 1:1 ) to receive either ( 1 ) a pedometer and website which provided goal - setting , feedback , disease-specific education , and an online community forum or ( 2 ) pedometer alone for 3 months . Primary outcome was change in daily step count . Secondary outcomes included 6MWT distance , HRQL , dyspnea , depression , COPD knowledge , exercise self-efficacy , social support , motivation , and confidence to exercise . Generalized linear mixed-effects models evaluated the effect of the pedometer plus website compared to pedometer alone . RESULTS Data from 109 subjects ( 98.5 % male , mean age 68.6 ± 8.3 years ) were analyzed . At 13 weeks , subjects in the pedometer plus website group had significant increases daily step count from baseline relative to the pedometer alone group ( 804 ± 356.5 steps per day , p = 0.02 ) . The pedometer plus website group had significant improvements in daily step count from baseline beginning in week 3 which were sustained until week 13 . In subgroup analyses , the pedometer plus website attenuated declines in daily step count during the transition from summer to fall . No significant differences in secondary outcomes were noted between groups . CONCLUSIONS A website added to pedometer use improves daily step counts , sustains walking over 3 months , and attenuates declines in physical activity due to season Background Low levels of physical activity are common in patients with chronic obstructive pulmonary disease ( COPD ) , and a sedentary lifestyle is associated with poor outcomes including increased mortality , frequent hospitalizations , and poor health-related quality of life .  Internet-mediated physical activity interventions may increase physical activity and improve health outcomes in persons with COPD . Methods / Design This manuscript describes the design and rationale of a r and omized controlled trial that tests the effectiveness of Taking Healthy Steps , an Internet-mediated walking program for Veterans with COPD .  Taking Healthy Steps includes an uploading pedometer , a website , and an online community .  Eligible and consented patients  wear a pedometer to obtain one week of baseline data and then are r and omized on a 2:1 ratio to Taking Healthy Steps or to a wait list control . The intervention arm receives iterative step-count feedback ; individualized step-count goals , motivational and informational messages , and access to an online community . Wait list controls are notified that they are enrolled , but that their intervention will start in one year ; however , they keep the pedometer and have access to a static webpage . Discussion Participants include 239 Veterans ( mean age 66.7 years , 93.7 % male ) with 155 r and omized to Taking Healthy Steps and 84 to the wait list control arm ; rural-living ( 45.2 % ) ; ever-smokers ( 93.3 % ) ; and current smokers ( 25.1 % ) . Baseline mean St. George ’s Respiratory Question naire Total Score was 46.0 ; 30.5 % reported severe dyspnea ; and the average number of comorbid conditions was 4.9 . Mean baseline daily step counts was 3497 ( + /- 2220).Veterans with COPD can be recruited to participate in an online walking program . We successfully recruited a cohort of older Veterans with a significant level of disability including Veterans who live in rural areas using a remote national recruitment strategy .Trial registration Clinical Trials.gov Background Pedometers have become common place in physical activity promotion , yet little information exists on who is using them . The multi- strategy , community-based 10,000 Steps Rockhampton physical activity intervention trial provided an opportunity to examine correlates of pedometer use at the population level . Methods Pedometer use was promoted across all intervention strategies including : local media , pedometer loan schemes through general practice , other health professionals and libraries , direct mail posted to dog owners , walking trail signage , and workplace competitions . Data on  pedometer use were collected during the 2-year follow-up telephone interviews from r and om population sample s in Rockhampton , Australia , and a matched comparison community ( Mackay ) . Logistic regression analyses were used to determine the independent influence of interpersonal characteristics and program exposure variables on pedometer use . Results Data from 2478 participants indicated that 18.1 % of Rockhampton and 5.6 % of Mackay participants used a  pedometer  in the previous 18-months . Rockhampton  pedometer  users ( n = 222 ) were more likely to be female ( OR = 1.59 , 95 % CI : 1.11 , 2.23 ) , aged 45 or older ( OR = 1.69 , 95 % CI : 1.16 , 2.46 ) and to have higher levels of education ( university degree OR = 4.23 , 95 % CI : 1.86 , 9.6 ) . Respondents with a BMI > 30 were more likely to report using a pedometer  ( OR = 1.68 , 95 % CI : 1.11 , 2.54 ) than those in the healthy weight range . Compared with those in full-time paid work , respondents in ' home duties ' were significantly less likely to report  pedometer use ( OR = 0.18 , 95 % CI : 0.06 , 0.53 ) . Exposure to individual program components , in particular seeing 10,000 Steps street signage and walking trails or visiting the website , was also significantly associated with greater  pedometer use . Conclusion  Pedometer use varies between population subgroups , and alternate strategies need to be investigated to engage men , people with lower levels of education and those in full-time ' home duties ' , when using pedometers in community-based physical activity promotion initiatives Background In Scotl and , older adults are a key target group for physical activity intervention due to the large proportion who are inactive . The health benefits of an active lifestyle are well established but more research is required on the most effective interventions to increase activity in older adults . The ' West End Walkers 65 + ' r and omised controlled trial aims to examine the feasibility of delivering a pedometer-based walking intervention to adults aged ≥65 years through a primary care setting and to determine the efficacy of this pilot . The study rationale , protocol and recruitment process are discussed in this paper . Methods / Design The intervention consisted of a 12-week pedometer-based graduated walking programme and physical activity consultations .  Participants were r and omised into an immediate intervention group ( immediate group  ) or a  12-week waiting list control group (  delayed group ) who then received the intervention . For the pilot element of this study , the primary outcome measure was pedometer step counts . Secondary outcome measures of sedentary time and physical activity ( time spent lying/sitting , st and ing or walking ; activPAL ™ monitor ) , mood ( Positive and Negative Affect Schedule ) , functional ability ( Perceived Motor-Efficacy Scale for Older Adults ) , quality of life ( Short-Form ( 36 ) Health Survey version 2 ) and loneliness ( UCLA Loneliness Scale ) were assessed . Focus groups with participants and semi-structured interviews with the research team captured their experiences of the intervention . The feasibility component of this trial examined recruitment via primary care and retention of participants , appropriateness of the intervention for older adults and the delivery of the intervention by a practice nurse . Discussion West End Walkers 65 + will determine the feasibility and pilot the efficacy of delivering a pedometer-based walking intervention through primary care to Scottish adults aged ≥65 years . The study will also examine the effect of the intervention on the well-being of participants and gain an insight into both participant and research team member experiences of the intervention . Trial registration numberIS RCT N : IS RCT AIM To study the effect of an intervention combining self-efficacy theory and pedometers on promoting physical activity among adolescents . BACKGROUND The beneficial effects of regular physical activity on health in youths are well-documented . However , adolescence is found to be the age of greatest decline in physical activity participation . Physical activity participation among girls was generally less frequent and less intense than boys . Therefore , there is a strong need for effective interventions that can help promote physical activity in this population . DESIGN An experimental design . METHODS Two classes of female junior college students ( mean age = 16 ) were r and omly sample d from a total of four classes and , of those , one each was r and omly assigned to either the intervention ( n = 46 ) or the control group ( n = 48 ) . Self-efficacy was used as a core theoretical foundation of the intervention design , and pedometers were provided to the students in the intervention group . Distances between each domestic scenic spot were illustrated graphically in a walking log for students to mark the extent of their walking or running . Students in the control group participated in a usual physical education programme . The primary outcome was a change in the number of aerobic steps . The secondary outcomes were changes in cardiopulmonary endurance and exercise self-efficacy . RESULTS At 12-week follow-up , the mean change in aerobic steps was 371 steps and 108 steps in the intervention and control group , respectively . The difference in mean change between the two groups was 467 steps . Effects of the intervention on changes of cardiopulmonary endurance and perceived exercise self-efficacy scores were not found . CONCLUSIONS Among adolescent girls , a 12-week intervention design ed on the theoretical foundation of self-efficacy theory and provision of pedometers was found to have an effect on increasing their physical activity . The intervention , using graphs of domestic scenic spots to represent the distance of walking or running as monitored by pedometers , might enhance motivation regarding physical activity . RELEVANCE TO CLINICAL PRACTICE It is important for health professionals , including school health nurses , involved in the care of adolescent health , to design and provide a physical activity intervention combining self-efficacy theory and provision of pedometer to promote physical activity OBJECTIVE To assess whether pedometers and text messaging increase physical activity in adolescents with type 1 diabetes . RESEARCH DESIGN AND METHODS A 12-week r and omized controlled trial was conducted . A total of 78 subjects participated in the trial ( mean ± SD age 14.4 ± 2.37 years , 36 [ 47 % ] male ) . Intervention participants wore an open pedometer and received regular motivational text messages . Control participants received usual care . Primary outcomes were daily step count ( 4-day closed pedometer ) and physical activity question naire . RESULTS Baseline median step count was 11,063 steps/day ( range 1,541–20,158 ) . At 12 weeks , mean daily step count reduced by 840 ( 95 % CI −1,947 to 266 ) in the control group and by 22 ( −1,407 to 1,364 ) in the intervention group ( P = 0.4 ) . Mean self-reported moderate or vigorous physical activity increased by 38.5 min/week in the control group and by 48.4 in the intervention group ( P = 0.9 ) . CONCLUSIONS A 12-week intervention using pedometers and text messaging as motivational tools in adolescents with type 1 diabetes  did not increase physical activity 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 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 ) BACKGROUND : In adults it is recommended that the minimum of 10,000 steps/day should be performed in order to consider an individual as active . The pedometer , a small device that counts steps , has been used to monitor and /or motivate physical activity in various population s. OBJECTIVE : To investigate the short-term effects of a protocol using a pedometer or an informative booklet to increase daily physical activity in apparently healthy smokers who reached or did not reach the minimum public health recommendation of 10,000 steps/day . METHODS : Subjects were r and omly assigned to 2 groups : group pedometer ( GP , n = 23 ) , who wore a pedometer every day during 1 month , aim ing to achieve 10,000 steps/day ; and group booklet ( GB , n = 17 ) , who received a booklet with encouragement to walk as much as possible in everyday life . Each group was subdivided according to their baseline daily physical activity level : active ( subjects who achieved 10,000 steps/day ) , and inactive ( those who did not achieve this minimum ) . RESULTS : Only the physically inactive GP increased significantly its daily physical activity ( pre vs post 7,670 [ 6,159–9,402 ] steps/day vs 10,310 [ 9,483–11,110 ] steps/day , P < .001 ) , with a concomitant increase in the 6-min walking test ( 6MWT ) distance ( mean and interquartile range 540 m [ 501–586 m ] vs 566 m [ 525–604 m ] , P = .03 ) . In GP , Δ post-pre steps/day correlated significantly with baseline number of steps/day ( r = −0.63 , P = .01 ) , but not with 6MWT . In the inactive subjects ( summing GP and GB ) , there were significant correlations between steps/day and cigarettes/day , pack-years , and Fagerström question naire ( r = −0.55 , −0.40 , and −0.59 , P ≤ .05 for all ) . Furthermore , improvement in steps/day in the inactive subjects of GP was correlated with baseline cigarettes smoked per day , pack-years , and Fagerström question naire ( r = 0.51 , 0.65 and 0.53 , P ≤ .05 for all ) . CONCLUSIONS : Physically inactive smokers improve their daily physical activity level by using a simple tool ( pedometer ) , and larger improvement occurs in subjects with the lowest levels of physical activity 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 In New Zeal and , meat processing population s face many health problems as a result of the nature of work in meat processing industries . The primary aim of this study was to examine the feasibility of using a pedometer-based intervention to increase physical activity and improve health-related outcomes in a population of meat processing workers . Methods A single-blinded r and omized controlled trial ( RCT ) was conducted . A convenience sample of meat workers ( n = 58 ; mean age 41.0 years ; range : 18 - 65 ) participated in the trial . Participants were r and omly allocated into two groups . Intervention participants ( n = 29 ) utilized a pedometer to self monitor their activity , whilst undertaking a brief intervention , and educational material .  Control participants ( n = 29 ) received educational material only . The primary outcomes of ambulatory activity , and health-related quality of life , were evaluated at baseline , immediately following the 12-week intervention and three months post-intervention . Results Fifty three participants completed the program ( 91.3 % adherence ) . Adherence with the intervention group was high , 93 % ( n = 27/29 ) , and this group increased their mean daily step count from 5993 to 9792 steps per day , while the control group steps changed from 5788 to 6551 steps per day from baseline . This increase in step counts remained significant within the intervention group p < 0.005 ; at three months post-intervention representing a 59 % increase over baseline scores . There were significant group changes with large effect sizes for step count change ( d = 1.94 ) and self-reported physical activity ( p < 0.005 ; d = 2.59 ) at 12 weeks intervention . Further , results showed non-significant between-group differences in physical component ( PCS ) and mental component ( MCS ) scores ( PCS : p = 0.44 ; MGD = 0.99 , 95 % CI , -1.6 to 3.6 ; ES = 0.14 , and MCS : p = 0.90 , MGD = 0.15 ; 95 % CI , -2.3 to 2.6 , ES = 0.022 ) at 12 weeks intervention . Conclusions This research provides important information for a larger ( RCT ) in the future : results demonstrated that a pedometer-driven walking intervention in combination with goal setting , and self-monitoring supported by weekly e-mails are feasible and potentially effective in increasing step count within the workplace setting over the short term . Trial registration numberAustralian New Zeal and Clinical Trials Registry ( ANZCTR ) ACTRN12613000087752 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 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 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 Introduction Physical activity participation is low among blacks , and strategies are needed to successfully create immediate and sustained behavior change related to physical activity . Churches can play an important role in health promotion efforts among blacks because of their central role in spiritual guidance , communication , social support , and networking . This pilot study evaluated the feasibility and acceptability of implementing a physical activity program for sedentary black adults in churches . Methods We used a preintervention/postintervention single-group design to evaluate the effect of a 3-month faith-based physical activity intervention on  daily walking and moderate- and vigorous-intensity physical activity  among sedentary blacks . Eighty-seven black adults participated in eight group sessions that included discussion of physical activity-related topics , an instructor-led physical activity session , and weekly incentives to promote physical activity . We used a question naire to assess moderate and vigorous physical activity in minutes per week at baseline and after 3 months . Walking was assessed weekly in steps per day by using a pedometer . Results Participants ( mean age , 52 yrs ; mean body mass index , 35 kg/m2 ) reported 27 ± 54 and 10 ± 25 minutes per week in moderate-intensity and vigorous-intensity physical activity , respectively , and walked 4822 ± 2351 steps per day at baseline . After 12 weeks , moderate- and vigorous-intensity physical activity increased by 67 ± 78 and 44 ± 66 minutes per week , respectively ( P ≤ .01 ) , and daily walking increased by 1373 ± 728 steps per day ( P < .001 ) . Conclusion These data suggest that a faith-based physical activity intervention may be an appropriate strategy for increasing physical activity among sedentary black adults . Future research will determine the impact of this program in a r and omized , controlled design 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 - OBJECTIVE 1 . To demonstrate that combining pedometer use with cognitive and behavioral support material s has a positive effect on  physical activity ( PA ) and attitudes towards pedometer  use . 2 . To investigate how familiar the study sample is with pedometers and the ' 10,000 steps/day ' recommendation . METHODS From a r and om sample , drawn from the phone book , 304 volunteered ( 18 - 75 year ) to complete a question naire about familiarity with pedometers and the ' 10,000 steps/day ' recommendation . A sample of 103 participants agreed to wear a pedometer  for 3 weeks , and was r and omly assigned to a condition with cognitive and behavioral support material s ( n=51 ) or without these material s ( n=52 ) . Participants completed the  International Physical Activity Question  naire before and after 21 days of pedometer use and an additional question naire on the attitudes towards pedometer use . RESULTS More than 58 % had never heard of a pedometer . In both conditions , walking ( F=10 , p=0.002 ) , moderate PA ( F=11 , p=0.001 ) , and vigorous PA ( F=14 , p<0.001 ) increased over time , however no interaction effects could be found . Significantly more participants in the condition with support material s had a positive attitude towards pedometer use . CONCLUSION Wearing a pedometer , with or without support material s , may increase PA . In our study , cognitive and behavioral support material s only affected attitudes towards pedometer use . PRACTICE IMPLICATION S More research is needed to investigate the effect of combining pedometer use with support material s on a longer time base and in less motivated people Objectives . The purpose of this study was to evaluate the effectiveness of the Walk Your Heart to Health ( WYHH ) intervention , one component of the multilevel Community Approaches to Cardiovascular Health : Pathways to Heart Health ( CATCH : PATH ) intervention design ed to promote physical activity and reduce cardiovascular risk among non-Hispanic Black and Hispanic residents of Detroit , Michigan . The study was design ed and implemented using a community-based participatory research approach that actively engaged community residents , health service providers and academic research ers . It was implemented between 2009 and 2012 . Method . WYHH was a 32-week community health promoter – facilitated walking group intervention . Groups met three times per week at community-based or faith-based organizations , and walked for 45 to 90 minutes ( increasing over time ) . The study used a cluster r and omized control design to evaluate effectiveness of WYHH , with participants r and omized into intervention or lagged intervention ( control ) groups . Psychosocial , clinical , and anthropometric data were collected at baseline , 8 , and 32 weeks , and pedometer step data tracked using uploadable peisoelectric pedometers . Results . Participants in the intervention group increased steps significantly more during the initial 8-week intervention period , compared with the control group ( β = 2004.5 , p = .000 ) . Increases in physical activity were associated with reductions in systolic blood pressure , fasting blood glucose , total cholesterol , waist circumference and body mass index at 8 weeks , and maintained at 32 weeks . Conclusion . The WYHH community health promoter – facilitated walking group intervention was associated with significant reductions in multiple indicators of cardiovascular risk among predominantly Hispanic and non-Hispanic Black participants in a low-to-moderate income urban community . Such interventions can contribute to reductions in racial , ethnic , and socioeconomic inequities in cardiovascular mortality BACKGROUND Although previous studies have reported physical activity and its sociodemographic determinants using self-report measures , there have been few studies using pedometers . PURPOSE To ascertain pedometer-determined physical activity and its sociodemographic determinants among community residents living in four Japanese cities . METHODS A cross-sectional mail survey was conducted from February 2007 to January 2008 with a sample of 4000 residents ( aged 20 - 69 years and 50 % male ) who were r and omly selected from the registry of residential addresses . Complete responses for both question naire and pedometer were obtained from 790 residents ( 48.3±13.7 years , 46.7 % male ) . Associations of 11 sociodemographic variables with steps per day were examined using multiple logistic regression analyses . Data were analyzed in 2010 . RESULTS Men averaged 8763±3497 steps/day and women averaged 8242±3277 steps/day . Further , 29.0 % of men and 27.8 % of women walked ≥10,000 steps/day . City of residence , good self-rated health , low educational attainment , and not owning a car were associated with taking ≥10,000 steps/day in men , whereas employed status and dog ownership were associated with walking ≥10,000 steps/day in women . CONCLUSIONS The results contribute to underst and ing of step-defined physical activity and its sociodemographic determinants . A diversity of step counts by sociodemographic variables clarifies specific population s among Japanese who are in need of intervention to promote physical activity
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 .