Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/26887
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Effect of a primary care walking intervention with and without nurse support on physical activity levels in 45- to 75-year-olds: The Pedometer And Consultation Evaluation (PACE-UP) cluster randomised clinical trial
Authors: Harris, Tess
Kerry, Sally M
Limb, Elizabeth S
Victor, Christina R
Iliffe, Steve
Ussher, Michael
Whincup, Peter H
Ekelund, Ulf
Fox-Rushby, Julia
Furness, Cheryl
Anokye, Nana
Ibison, Judith
DeWilde, Steve
David, Lee
Howard, Emma
Issue Date: 3-Jan-2017
Citation: Harris T, Kerry SM, Limb ES, Victor CR, Iliffe S, Ussher M, Whincup PH, Ekelund U, Fox-Rushby J, Furness C, Anokye N, Ibison J, DeWilde S, David L & Howard E (2017) Effect of a primary care walking intervention with and without nurse support on physical activity levels in 45- to 75-year-olds: The Pedometer And Consultation Evaluation (PACE-UP) cluster randomised clinical trial, PLoS Medicine, 14 (1), Art. No.: e1002210.
Abstract: Background:  Pedometers can increase walking and moderate-to-vigorous physical activity (MVPA) levels, but their effectiveness with or without support has not been rigorously evaluated. We assessed the effectiveness of a pedometer-based walking intervention in predominantly inactive adults, delivered by post or through primary care nurse-supported physical activity (PA) consultations.    Methods and Findings:  A parallel three-arm cluster randomised trial was randomised by household, with 12-mo follow-up, in seven London, United Kingdom, primary care practices. Eleven thousand fifteen randomly selected patients aged 45–75 y without PA contraindications were invited. Five hundred forty-eight self-reporting achieving PA guidelines were excluded. One thousand twenty-three people from 922 households were randomised between 2012–2013 to one of the following groups: usual care (n = 338); postal pedometer intervention (n = 339); and nurse-supported pedometer intervention (n = 346). Of these, 956 participants (93%) provided outcome data (usual care n = 323, postal n = 312, nurse-supported n = 321). Both intervention groups received pedometers, 12-wk walking programmes, and PA diaries. The nurse group was offered three PA consultations. Primary and main secondary outcomes were changes from baseline to 12 mo in average daily step-counts and time in MVPA (in ≥10-min bouts), respectively, measured objectively by accelerometry. Only statisticians were masked to group. Analysis was by intention-to-treat. Average baseline daily step-count was 7,479 (standard deviation [s.d.] 2,671), and average time in MVPA bouts was 94 (s.d. 102) min/wk. At 12 mo, mean steps/d, with s.d. in parentheses, were as follows: control 7,246 (2,671); postal 8,010 (2,922); and nurse support 8,131 (3,228). PA increased in both intervention groups compared with the control group; additional steps/d were 642 for postal (95% CI 329–955) and 677 for nurse support (95% CI 365–989); additional MVPA in bouts (min/wk) were 33 for postal (95% CI 17–49) and 35 for nurse support (95% CI 19–51). There were no significant differences between the two interventions at 12 mo. The 10% (1,023/10,467) recruitment rate was a study limitation.  Conclusions: A primary care pedometer-based walking intervention in predominantly inactive 45- to 75-y-olds increased step-counts by about one-tenth and time in MVPA in bouts by about one-third. Nurse and postal delivery achieved similar 12-mo PA outcomes. A primary care pedometer intervention delivered by post or with minimal support could help address the public health physical inactivity challenge.
DOI Link: http://dx.doi.org/10.1371/journal.pmed.1002210
Rights: © 2017 Harris et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Notes: Additional co-authors: Dale R, Smith J, Cook DG

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