Move to Improve: a randomized workplace trial to increase physical activity. Comparison of two email-delivered, pedometer-based interventions to promote walking among insufficiently active women. Growing healthy families: family use of pedometers to increase physical activity and slow the rate of obesity. Effectiveness of telephone support in increasing physical activity levels in primary care patients. Effects of integrating pedometers, parental materials, and E-mail support within an extracurricular school sport intervention. Advising people to take more exercise is ineffective: a randomized controlled trial of physical activity promotion in primary care. Outcomes of a field trial to improve children's dietary patterns and physical activity. The Child and Adolescent Trial for Cardiovascular Health. CATCH collaborative group. Impact of Promoting Lifestyle Activity for Youth (PLAY) on children's physical activity. Effect of individual counseling on physical activity fitness and health: a randomized controlled trial in a workplace setting.
Workplaces are important settings for interventions to increase physical activity, but effects have been modest.
                To evaluate the efficacy of Move to Improve, a social-ecologic intervention delivered at the workplace to increase leisure-time physical activity.
                A group-randomized 12-week intervention consisting of organizational action and personal and team goal-setting was implemented in Fall 2005, with a multi-racial/ethnic sample of 1442 employees at 16 worksites of The Home Depot, Inc. Change in physical activity was analyzed in Fall 2007 using latent growth modeling and latent transition analysis.
                Participants in the intervention had greater increases in moderate and vigorous physical activity and walking compared to participants in a health education control condition. The proportion of participants that met the Healthy People 2010 recommendation for regular participation in either moderate or vigorous physical activity remained near 25% at control sites during the study but increased to 51% at intervention sites. During the last 6 weeks of the study, intervention participants exceeded 300 weekly minutes of self-reported moderate-to-vigorous physical activity and 9000 daily pedometer steps.
                The results support the feasibility and efficacy of the Move to Improve intervention and the role of goal-setting for attaining increased physical activity levels. Research on the effect of email-delivered, pedometer-based interventions on walking behavior and transtheoretical model (TTM) constructs is lacking. Therefore, the purpose of this study was to compare the effectiveness of two email-delivered, pedometer-based interventions designed to increase walking and TTM construct scores among insufficiently active women. Participants were randomly assigned to one of two 6-week intervention groups. Both groups wore pedometers, submitted step logs, and received weekly email reminders. One group also received in the emails suggested strategies based on TTM for increasing physical activity. Of the 74 women who began the study, 56 (age=41.5+/-7.6 years; body mass index=31.2+/-6.6kg/m(2); 86% Caucasian) completed the International Physical Activity Questionnaire and TTM questionnaires at baseline and post-intervention. Participants in both groups combined increased weekly time spent walking (p=0.002) and their scores on TTM cognitive processes, behavioral processes, pros, and cons changed (p< or =0.001) from baseline to post-intervention. The changes in walking and TTM scores did not differ between groups (p>0.05). The results of this study indicate that email-delivered, pedometer-based interventions may impact walking and most TTM scores among insufficiently active women. Although preliminary, the findings provide additional evidence that this low-cost method of intervening may be an effective approach to combat physical inactivity in women. We conducted a study to determine if wearing a pedometer affects weight, body mass index (BMI), or mediators of physical activity among families.
                Eighty-seven families were randomized to 1 of 3 treatments: pedometer plus education (PE), pedometer (P), or control (C). Participants in the PE and P groups wore pedometers and were encouraged to walk 10,000 steps daily for 12 weeks. PE group participants attended 6 sessions on healthy eating and exercise. Participants were surveyed about their knowledge and attitudes about healthy eating and physical activity prior to randomization, at the end of the intervention, and 9 months later. Their heights and weights were measured and BMI calculated.
                Children's BMI percentile decreased from baseline to end of intervention (-0.18%) and at 9-month follow-up (-0.08%) but did not differ by treatment. Children's BMI percentile varied by parental obesity status (average BMI percentile was 88.7% for children of obese parents and 78.5% for children of non-obese parents). Parents' weight decreased slightly by intervention's end (0.6 pounds) and at 9 months (1.2 pounds), but change was similar among groups. Attitudes about their physical activity level relative to their peers improved significantly among children and parents wearing the pedometer. Self-efficacy improved for parents wearing the pedometer. Both children and parents felt the pedometer increased their activity level, but most were unlikely to wear it beyond the intervention.
                The pedometer had little impact on the activity level, weight, or BMI of participants. Physician counseling of patients to increase physical activity has had limited success in changing behavior. Providing organizational support to primary care providers and their patients may increase effectiveness.
                This study evaluates the effectiveness of a telephone-based intervention to increase physical activity among patients who exercised <15 minutes daily and wanted to increase their physical activity over a 6-month period.
                This was a randomized controlled trial, conducted from 1997 to 1998, of 316 patients aged 18 to 65 who were recruited from a mailed health risk assessment. Baseline and 6-month post-intervention telephone assessments were conducted by telephone.
                One family physician's patients in a suburban community.
                Three sessions of telephone-delivered motivational counseling.
                Physical activity score (11-item Physician-Based Assessment and Counseling for Exercise [PACE]) 6 months after the intervention.
                After adjusting for baseline exercise, there was a significantly higher level of self-reported exercise among individuals randomized to the intervention at the 6-month follow-up. The mean level of activity at follow-up for the intervention group was a PACE score of 5.37, compared to 4.98 in the control group (p<0.05). In the secondary analysis, which was limited to individuals who received the intervention, the effect was stronger (PACE score of 5.58 compared to 4.94, p<0.013).
                Patients can be recruited using a health-screening questionnaire to receive a telephone-delivered behavioral intervention to successfully increase their physical activity levels. The objective of this study was to evaluate the impact of a school-based intervention (Program X) incorporating pedometers and e-mail support on physical activity, sedentary behavior, and healthy eating in adolescents.
                A randomized control trial was used to evaluate the impact of the Program X intervention. Six schools (N = 124 participants; mean age 14.1 +/- .8 years) were randomized to intervention or control conditions for the 6-month study period. Objectively recorded physical activity (mean steps/day), self-reported sedentary behavior, and dietary habits were measured at baseline and at 6-month follow-up and intervention effects were assessed using repeated-measures analysis of variance and chi(2) tests.
                Participants in the intervention group increased their step counts by 956 +/- 4107 steps/day (boys) and 999 +/- 1999 (girls). Repeated-measures analysis of variance revealed significant group-by-time interactions for boys (F = 7.4, p = .01, d = .80) and girls (F = 29.6, p <.001, d = 1.27) for mean steps/day. The intervention significantly decreased the number of energy-dense/low-nutrient snacks consumed by boys (chi(2) = 4.0, p = .043) and increased the number of fruit serves among girls (chi(2) = 4.8, p = .028). The intervention did not have a statistically significant effect on sedentary behavior.
                A school-based intervention incorporating physical activity monitoring using pedometers and e-mail support was successful in promoting physical activity and selected healthy eating behaviors in adolescent boys and girls. Over the last 10 years 'exercise referral schemes' have been popular even though the evidence for effectiveness of any one-to-one intervention in primary care is deficient. We report the results of a primary care based one-to-one intervention that compared the effect of two communication styles with a no-intervention control group on self-reported physical activity at 12 months.
                In all, 1658 middle-aged men and women were randomly assigned to 30 minutes of brief negotiation or direct advice in primary care or a no-intervention control group. The main outcome was self-reported physical activity at 12 months. Secondary outcome measures included change in blood pressure and body mass index.
                Intention-to-treat analysis revealed no significant differences in physical activity between groups. Brief negotiation group participants who completed the study increased their physical activity significantly more than controls. There was no change in body mass index in any group. The brief negotiation group produced a greater reduction in diastolic blood pressure than direct advice.
                If patients whose health may benefit from increased physical activity seek advice in primary care, 20-30 minutes of brief negotiation to increase physical activity is probably more effective than similar attempts to persuade or coerce. However, blanket physical activity promotion in primary care is not effective. The most effective way of increasing physical activity in primary care has yet to be determined. To assess the outcomes of health behavior interventions, focusing on the elementary school environment, classroom curricula, and home programs, for the primary prevention of cardiovascular disease.
                A randomized, controlled field trial at four sites with 56 intervention and 40 control elementary schools. Outcomes were assessed using prerandomization measures (fall 1991) and follow-up measures (spring 1994).
                A total of 5106 initially third-grade students from ethnically diverse backgrounds in public schools located in California, Louisiana, Minnesota, and Texas.
                Twenty-eight schools participated in a third-grade through fifth-grade intervention including school food service modifications, enhanced physical education (PE), and classroom health curricula. Twenty-eight additional schools received these components plus family education.
                At the school level, two primary end points were changes in the fat content of food service lunch offerings and the amount of moderate-to-vigorous physical activity in the PE programs. At the level of the individual student, serum cholesterol change was the primary end point and was used for power calculations for the study. Individual level secondary end points included psychological factors, recall measures of eating and physical activity patterns, and other physiologic measures.
                In intervention school lunches, the percentage of energy intake from fat fell significantly more (from 38.7% to 31.9%) than in control lunches (from 38.9% to 36.2%)(P<.001). The intensity of physical activity in PE classes during the Child and Adolescent Trial for Cardiovascular Health (CATCH) intervention increased significantly in the intervention schools compared with the control schools (P<.02). Self-reported daily energy intake from fat among students in the intervention schools was significantly reduced (from 32.7% to 30.3%) compared with that among students in the control schools (from 32.6% to 32.2%)(P<.001). Intervention students reported significantly more daily vigorous activity than controls (58.6 minutes vs 46.5 minutes; P<.003). Blood pressure, body size, and cholesterol measures did not differ significantly between treatment groups. No evidence of deleterious effects of this intervention on growth or development was observed.
                The CATCH intervention was able to modify the fat content of school lunches, increase moderate-to-vigorous physical activity in PE, and improve eating and physical activity behaviors in children during 3 school years. This study examined effects of a school-based intervention called PLAY (Promoting Lifestyle Activity for Youth) on physical activity levels and body mass index (BMI) of students. Participants included 606 fourth-grade students selected from a stratified sample of 35 schools in Arizona and placed into four groups: PLAY & PE, PLAY Only, PE Only, and No Treatment. A treatment-control, post-measurement design assessed physical activity using the YAMAX pedometer, and height and weight data were collected following the intervention. One-way ANOVAs were used to analyze the data. Results indicated the treatment was effective at increasing the physical activity level of children, especially girls. No significant differences between groups were found for BMI. Programs such as PLAY, which can increase the activity level of children, may have significant health implications for youth. Physical inactivity and obesity are major public health problems. Our objective was to investigate the effectiveness of an individual counseling intervention at the workplace on physical activity fitness and health. Counseling content derived from the Patient-centered Assessment and Counseling for Exercise and Nutrition (PACE) program.
                A total of 299 employees of three municipal services in the Dutch town of Enschede were randomly allocated into intervention (n =131) and control group (n =168). Over a 9-month period, intervention group subjects were offered seven counseling sessions. Counseling was based on the individual's stage of behavioral change using PACE physical activity and nutrition protocols. Subjects in both the intervention and control group received written information about several lifestyle factors. Primary outcome measures were physical activity (total energy expenditure, during sports activities, during physical activity leisure time other than sports, and meeting the moderate-intensity public health recommendations); cardiorespiratory fitness; and prevalence of musculoskeletal symptoms. Secondary outcome measures were body composition (body mass index [BMI], and percentage of body fat measured via skinfold thicknesses); blood pressure; and blood cholesterol.
                There were significant positive effects on total energy expenditure, physical activity during sports, cardiorespiratory fitness, percentage of body fat, and blood cholesterol. No effects were found for the proportion of subjects meeting the public health recommendation of moderate-intensity physical activity, physical activity during leisure time other than sports, prevalence of musculoskeletal symptoms, body mass index, and blood pressure.
                Individual face-to-face counseling at the workplace based on PACE protocols positively influenced physical activity levels and some components of physical fitness. The implementation of workplace counseling programs for individuals should therefore be promoted.
There was limited and low quality data providing insufficient evidence to assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving subsequent health outcomes.