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

Abstract

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 randomly 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

Introduction

Regular physical activity is associated with a reduced risk of several chronic diseases as well as all-cause mortality (Bauman, 2004, Nocon et al., 2008, Paffenbarger and Lee, 1997). Despite an increased focus on the health benefits of physical activity during the past two decades, a large part of the Danish population is physically inactive (Petersen et al., 2010). Hence, knowledge of easily incorporable and cost-effective population-based interventions to increase physical activity is needed.

Walking is a popular and simple form of exercise. Pedometers are small inexpensive devices and the immediate feedback on the number of steps taken has been found to be a motivating tool for increasing physical activity (Bravata et al., 2007, Chan et al., 2004, Engel and Lindner, 2006, Kang et al., 2009, Tudor-Locke and Lutes, 2009). However, motivation most likely depends on individual goals (Bravata et al., 2007, Hultquist et al., 2005). Pedometer-based programs that aim at reaching a self-set individual goal are inexpensive and easy to manage. Thus, they have the potential of reaching a large part of the population, including those who may not wish to participate in organized sports and exercise.

Among chronically ill patients, pedometer-based goal-setting interventions seem to be efficacious in increasing the number of daily steps (Moreau et al., 2001, Talbot et al., 2003, Yamanouchi et al., 1995). Further, increased walking time may also have a positive effect on mood (Ekkekakis et al., 2000, Murphy et al., 2007). However, few have examined the effect of a combined pedometer and goal-setting intervention in the general population and results are inconsistent (Baker et al., 2008, Chan and Tudor-Locke, 2008, Hultquist et al., 2005, Rooney et al., 2005, Sidman et al., 2004, Sugiura et al., 2002). Many of these studies lack a control group, implement numerous interventions simultaneously, include few participants and have large drop-out rates. The aim of this study was to investigate the effect of receiving a pedometer and an intervention toolkit including a self-guided step goal booklet and a logbook on physical activity, aerobic fitness and self-rated health in a population-based approach.