Article
Details
Citation
Harris T, Kerry SM, Limb ES, Furness C, Wahlich C, Victor CR, Iliffe S, Whincup PH, Ussher M, Ekelund U, Fox-Rushby J, Ibison J, DeWilde S, McKay C & Cook DG (2018) Physical activity levels in adults and older adults 3¨C4 years after pedometer-based walking interventions: Long-term follow-up of participants from two randomised controlled trials in UK primary care. PLOS Medicine, 15 (3), Art. No.: e1002526. https://doi.org/10.1371/journal.pmed.1002526
Abstract
Background
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¨C4 years.
Methods and findings
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¨C75 years, PACE-Lift: 60¨C75 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 ¡Ý10-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¨C1,056), p = 0.004, nurse +670 (95% CI: 237¨C1,102), p = 0.002; total weekly MVPA in bouts (minutes/week) postal +28 (95% CI: 7¨C49), p = 0.009, nurse +24 (95% CI: 3¨C45), p = 0.03. PACE-Lift 4-year intervention versus control comparisons were: +407 (95% CI: ?177¨C992), p = 0.17 steps/day, and +32 (95% CI: 5¨C60), 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.
Conclusions
Intervention participants followed up from both trials demonstrated higher levels of objectively measured PA at 3¨C4 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.
Trial registrations
PACE-UP isrctn.com ISRCTN98538934; PACE-Lift isrctn.com ISRCTN42122561.
Journal
PLOS Medicine: Volume 15, Issue 3
| Status | Published |
|---|---|
| Funders | Health Technology Assessment Programme and Research for Patient Benefit Programme |
| Publication date | 31/03/2018 |
| Publication date online | 31/03/2018 |
| Date accepted by journal | 06/02/2018 |
| URL | |
| Publisher | Public Library of Science (PLoS) |
| ISSN | 1549-1277 |
| eISSN | 1549-1676 |
People (1)
Professor of Behavioural Medicine, Institute for Social Marketing