Journal Article

Physical activity levels in adults and older adults 3–4 years after pedometer-based walking interventions: Long-term follow-up of participants from two randomised controlled trials in UK primary care

Fox-Rushby, Julia, Wahlich, Charlotte, DeWilde, Stephen, Furness, Cheryl, McKay, Cathy, Limb, Elizabeth S., Iliffe, Steve, Ekelund, Ulf, Ussher, Michael, Cook, Derek G., Harris, Tess, Ibison, Judith, Kerry, Sally M., Victor, Christina R., Whincup, Peter H.

2018

Overview

Physical inactivity is an important cause of noncommunicable diseases. Interventions can increase short-term physical activity (PA), but health benefits require maintenance. Few interventions have evaluated PA objectively beyond 12 months. We followed up two pedometer interventions with positive 12-month effects to examine objective PA levels at 3-4 years. Long-term follow-up of two completed trials: Pedometer And Consultation Evaluation-UP (PACE-UP) 3-arm (postal, nurse support, control) at 3 years and Pedometer Accelerometer Consultation Evaluation-Lift (PACE-Lift) 2-arm (nurse support, control) at 4 years post-baseline. Randomly selected patients from 10 United Kingdom primary care practices were recruited (PACE-UP: 45-75 years, PACE-Lift: 60-75 years). Intervention arms received 12-week walking programmes (pedometer, handbooks, PA diaries) postally (PACE-UP) or with nurse support (PACE-UP, PACE-Lift). Main outcomes were changes in 7-day accelerometer average daily step counts and weekly time in moderate-to-vigorous PA (MVPA) in ≥10-minute bouts in intervention versus control groups, between baseline and 3 years (PACE-UP) and 4 years (PACE-Lift). PACE-UP 3-year follow-up was 67% (681/1,023) (mean age: 59, 64% female), and PACE-Lift 4-year follow-up was 76% (225/298) (mean age: 67, 53% female). PACE-UP 3-year intervention versus control comparisons were as follows: additional steps/day postal +627 (95% CI: 198-1,056), p = 0.004, nurse +670 (95% CI: 237-1,102), p = 0.002; total weekly MVPA in bouts (minutes/week) postal +28 (95% CI: 7-49), p = 0.009, nurse +24 (95% CI: 3-45), p = 0.03. PACE-Lift 4-year intervention versus control comparisons were: +407 (95% CI: -177-992), p = 0.17 steps/day, and +32 (95% CI: 5-60), p = 0.02 minutes/week MVPA in bouts. Neither trial showed sedentary or wear-time differences. Main study limitation was incomplete follow-up; however, results were robust to missing data sensitivity analyses. Intervention participants followed up from both trials demonstrated higher levels of objectively measured PA at 3-4 years than controls, similar to previously reported 12-month trial effects. Pedometer interventions, delivered by post or with nurse support, can help address the public health physical inactivity challenge. PACE-UP isrctn.com ISRCTN98538934; PACE-Lift isrctn.com ISRCTN42122561.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Accelerometry - methods / Actigraphy - methods / Adults / Aftercare - methods / Aged / Behavior / Biology and Life Sciences / Cardiovascular disease / Clinical trials / Consultation / Data processing / Elderly / Engineering and Technology / Evaluation / Exercise / Exercise - physiology / Exercise - psychology / Exercise Therapy - methods / Exercise Therapy - nursing / Exercise Therapy - psychology / Female / Funding / Handbooks / Health aspects / Health behavior / Health Promotion - methods / Humans / Intervention / Male / Medical research / Medicine and Health Sciences / Middle Aged / Missing data / Noncommunicable Diseases - epidemiology / Noncommunicable Diseases - prevention & control / Nursing Care - methods / Older people / People and Places / Physical activity / Population / Primary care / Primary Health Care - methods / Program Evaluation / Public health / Referral and Consultation / Research centers / Supervision / Systematic review / Walking / Walking - physiology / Walking - psychology / Weight control