The 'Walking for Wellbeing in the West' randomised controlled trial of a pedometer-based walking programme in combination with physical activity consultation with 12 month follow-up: rationale and study design

Claire F Fitzsimons, Graham Baker, Annemarie Wright, Myra A Nimmo, Catharine Ward Thompson, Ruth Lowry, Catherine Millington, Rebecca Shaw, Elisabeth Fenwick, David Ogilvie, Joanna Inchley, Charlie E Foster, Nanette Mutrie, Claire F Fitzsimons, Graham Baker, Annemarie Wright, Myra A Nimmo, Catharine Ward Thompson, Ruth Lowry, Catherine Millington, Rebecca Shaw, Elisabeth Fenwick, David Ogilvie, Joanna Inchley, Charlie E Foster, Nanette Mutrie

Abstract

Background: Scotland has a policy aimed at increasing physical activity levels in the population, but evidence on how to achieve this is still developing. Studies that focus on encouraging real world participants to start physical activity in their settings are needed. The Walking for Well-being in the West study was designed to assess the effectiveness of a pedometer-based walking programme in combination with physical activity consultation. The study was multi-disciplinary and based in the community. Walking for Well-being in the West investigated whether Scottish men and women, who were not achieving the current physical activity recommendation, increased and maintained walking behaviour over a 12 month period. This paper outlines the rationale and design of this innovative and pragmatic study.

Methods: Participants were randomised into two groups: Group 1: Intervention (pedometer-based walking programme combined with a series of physical activity consultations); Group 2: Waiting list control for 12 weeks (followed by minimal pedometer-based intervention). Physical activity (primary outcome) was measured using pedometer step counts (7 day) and the International Physical Activity Questionnaire (long version). Psychological processes were measured using questionnaires relating to the Transtheoretical Model of Behaviour Change, mood (Positive and Negative Affect Schedule) and quality of life (Euroqol EQ-5D instrument). Physiological measures included anthropometric and metabolic outcomes. Environmental influences were assessed subjectively (Neighbourhood Quality of Life Survey) and objectively (neighbourhood audit tool and GIS mapping). The qualitative evaluation employed observation, semi-structured interviews and focus groups. A supplementary study undertook an economic evaluation.

Discussion: Data analysis is on-going. Walking for Well-being in the West will demonstrate if a pedometer based walking programme, in combination with physical activity consultation results in a sustainable increase in walking behaviour in this sample of Scottish adults over a 12 month period. The study will examine the complex relationships between behavioural change, health consequences and the role of the environment, in conjunction with the cost effectiveness of this approach and a detailed insight into the participants' experiences of the intervention.

Trial registration: Current Controlled Trials ISRCTN88907382.

Figures

Figure 1
Figure 1
Flowchart of participant recruitment and trial design.

References

    1. Scottish Executive . let's make Scotland more active. Edinburgh , Scottish Executive; 2003.
    1. The Scottish Office . In: The Scottish Health Survey (1998) Vol 1. The Stationary Office, editor. Edinburgh ; 2000.
    1. Vaz de Almeida MD, Grac. a P, Afonso C, Amicis A, Lappalainen R, Damkjaer S. Physical activity levels and body weight in a nationally representative sample in the European Union. Public Health Nutrition. 1999;2:105–113. doi: 10.1017/S1368980099000154.
    1. Mutrie N, Hannah MK. Some work hard while others play hard: the achievement of current recommendations for physical activity levels at work, home, and in leisure in the West of Scotland. International Journal of Health Promotion and Education. 2004;42:109–117.
    1. Department of Health At least 5 a week: Evidence of the impact of physical activity and its relationship to health. A report from the Chief Medical Officer. Department of Health: London. 2004.
    1. Scottish Executive . The Scottish Health Survey 2003. Edinburgh: Crown Copyright ; 2005.
    1. Physical Activity and Health Alliance Physical Activity and Inequalities. NHS Health Scotland. 2007.
    1. Ogilvie D, Foster CE, Rothnie H, Cavill N, Hamilton V, Fitzsimons CF, Mutrie N, on behalf of the Scottish Physical Activity Research C. Interventions to promote walking: systematic review. BMJ. 2007;334:1204. doi: 10.1136/.
    1. Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R, Stave CD, Olkin I, Sirard JR. Using pedometers to increase physical activity and improve health. JAMA. 2007;298:2296–2304. doi: 10.1001/jama.298.19.2296.
    1. National Institute for Clinical Excellence Four commonly used methods to increase physical activity: brief interventions in primary care, exercise referral schemes, pedometers and community-based exercise programmes for walking and cycling. 2006.
    1. MacDonald G. Veen C. Tones K Evidence for success in health promotion: suggestions for improvement. Health Education Research. 1996;11:367–376. doi: 10.1093/her/11.3.367.
    1. Tannahill A . In: Health Promotion - discipline and diversity. Bunton R, MacDonald G, editor. London , Routledge; 1992.
    1. Scottish Government Scottish Index of Multiple Deprivation. 2008.
    1. Loughlan CW, Mutrie N. Recruitment of sedentary NHS staff for a workplace exercise program using an adapted "stages of change" exercise questionnaire. Journal of Sports Science. 1995;15:100.
    1. Thomas S, Reading J, Shephard RJ. Revision of the Physical Activity Readiness Questionnaire (PAR-Q) Can J Sport Sci. 1992;17:338–345.
    1. Jordan AN, Jurca GM, Locke CT, Church TS, Blair SN. Pedometer indices for weekly physical activity recommendations in postmenopausal women. Med Sci Sports Exerc. 2005;37:1627–1632. doi: 10.1249/01.mss.0000177455.58960.aa.
    1. Tudor-Locke C, Ainsworth BE, Thompson RW, Matthews CE. Comparison of pedometer and accelerometer measures of free-living physical activity. Med Sci Sports Exerc. 2002;34:2045–2051. doi: 10.1097/00005768-200205001-01283.
    1. Kobayashi J, Murase Y, Asano A, Nohara A, Kawashiri M, Inazu A, Yamagishi M, Mabuchi H. Effect of Walking with a Pedometer on Serum Lipid and Adiponectin Levels in Japanese Middle-aged Men. Journal of Atherosclerosis and Thrombosis. 2006;13:197–201.
    1. Hughes AR, Mutrie N, MacIntyre PD. Effect of an exercise consultation on maintenance of physical activity after completion of phase III exercise-based cardiac rehabilitation. European Journal of Cardiovascular Prevention & Rehabilitation. 2007;14:114–121. doi: 10.1097/HJR.0b013e3280116485.
    1. Kirk A, Mutrie N, MacIntyre P, M F. Effects of a 12-month physical activity counselling intervention on glycaemic control and on the status of cardiovascular risk factors in people with Type 2 diabetes . Diabetologia. 2004;47:821–832. doi: 10.1007/s00125-004-1396-5.
    1. Lowther M, Mutrie N, Scott EM. Promoting physical activity in a socially and economically deprived community: a 12 month randomized control trial of fitness assessment and exercise consultation. Journal of Sports Science. 2002;20:577–588. doi: 10.1080/026404102760000071.
    1. Tudor-Locke C, Sisson SB, Collova T, Lee SM, Swan PD. Pedometer-determined step count guidelines for classifying walking intensity in a young ostensibly healthy population. Canadian Journal of Applied Physiology. 2005;30:666–676.
    1. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P, Group IPAQC, IPAQ Relaibility and Validity Study Group International Physical Activity Questionnaire (IPAQ) Med Sci Sports Exerc. 2003;35:1382–1395. doi: 10.1249/01.MSS.0000078924.61453.FB.
    1. Marcus BH, Simkin LR. The transtheoretical model: applications to exercise behaviour. Med Sci Sports Exerc. 1994;26:1400–1404.
    1. Watson D, Clarka LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS Scales. Journal of Personality and Social Psychology. 1988;54:1063–1070. doi: 10.1037/0022-3514.54.6.1063.
    1. EuroQol Group EuroQol--a new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199–208. doi: 10.1016/0168-8510(90)90421-9.
    1. Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med. 2005;352:1685–1695. doi: 10.1056/NEJMra043430.
    1. Landi S, Moreno V, Gioia-Patricola L, Guino E, Navarro M, de Oca J, Capella G, Canzian F. Association of Common Polymorphisms in Inflammatory Genes Interleukin (IL)6, IL8, Tumor Necrosis Factor {alpha}, NFKB1, and Peroxisome Proliferator-activated Receptor {gamma} with Colorectal Cancer. Cancer Res. 2003;63:3560–3566.
    1. Hallenbeck JM. The many faces of tumor necrosis factor in stroke. Nat Med. 2002;8:1363–1368. doi: 10.1038/nm1202-1363.
    1. Pradhan AD, Manson JAE, Rifai N, Buring JE, Ridker PM. C-Reactive Protein, Interleukin 6, and Risk of Developing Type 2 Diabetes Mellitus. JAMA. 2001;286:327–334. doi: 10.1001/jama.286.3.327.
    1. Scottish Executive Scottish Diabetes Survey 2005. 2007.
    1. Coronary Heart Disease/Stroke Task Force Report (accessed 19 June 2007)
    1. Bruunsgaard H. Physical activity and modulation of systemic low-level inflammation. Journal of Leukocyte Biology. 2005;78:819–835. doi: 10.1189/jlb.0505247.
    1. Kohut ML, McCann DA, Russell DW, Konopka DN, Cunnick JE, Franke WD, Castillo MC, Reighard AE, Vanderah E. Aerobic exercise, but not flexibility/resistance exercise, reduces serum IL-18, CRP, and IL-6 independent of [beta]-blockers, BMI, and psychosocial factors in older adults. Brain, Behavior, and Immunity. 2006;20:201–209. doi: 10.1016/j.bbi.2005.12.002.
    1. Owen N, Humpel N, Leslie E, Bauman A, Sallis JF. Understanding environmental influences on walking: review and research agenda. American Journal of Preventive Medicine. 2004;27:67–76. doi: 10.1016/j.amepre.2004.03.006.
    1. Sallis JF, Owen N. In: Physical activity and behavioral medicine. Thousand Oaks, editor. CA: Sage ; 1999.
    1. Humpel N, Marshall AL, Leslie E, Bauman A, Owen N. Changes in neighbourhood walking are related to changes in perceptions of environmental attributes. Annals of Behavioral Medicine. 2004:60–67. doi: 10.1207/s15324796abm2701_8.
    1. Humpel N, Owen N, Leslie E. Environmental factors associated with adults' participation in physical activity. American Journal of Preventive Medicine. 2002;22:188–199. doi: 10.1016/S0749-3797(01)00426-3.
    1. Hovell MF, Sallis JF, Hofstetter CR, Spry VM, Faucher PF, Caspersen CJ. Identifying correlates of walking for exercise: an epidemiologic prerequisite for physical activity promotion. . Preventive Medicine. 1989;18:856–866. doi: 10.1016/0091-7435(89)90021-2.
    1. Calfas KJ, Sallis JF, Lovato CY, Campbell J. Physical activity and its determinants before and after college graduation. Medicine, Exercise, Nutrition, and Health. 1994;3:323–334.
    1. Sallis JF, Grossman RM, Pinski RB, Patterson TL, Nader PR. The development of scales to measure social support for diet and exercise behaviors. Preventive Medicine. 1987;16:825–836. doi: 10.1016/0091-7435(87)90022-3.
    1. Sampson RJ, Raudenbush SW, Earls F. Neighbourhoods and violent crime: A multi-level study of collective efficacy. Science. 1997;287:918–924. doi: 10.1126/science.277.5328.918.
    1. Pikora TJ, Bull FCL, Jamrozik K, Knuiman M, Giles-Corti B, Donovan R. Developing a reliable audit instrument to measure the physical environment for physical activity. American Journal of Preventive Medicine. 2002;23:187–194. doi: 10.1016/S0749-3797(02)00498-1.
    1. Giles-Corti B, Timperio A, Bull FCL, Pikora TJ. Understanding physical activity environmental correlates: increased specificity for ecological models. Exerc Sport Sci Rev. 2005;33:175–181. doi: 10.1097/00003677-200510000-00005.
    1. De Bourdeaudhuij I, Sallis JF, Saelens BE. Environmental correlates of physical activity in a sample of Belgian adults. American Journal of Health Promotion. 2003;18:83–92.
    1. Giles-Corti B, Donovan R. The relative influence of individual, social and physical environment determinants of physical activity. Social Science and Medicine. 2002;54:1793–1812. doi: 10.1016/S0277-9536(01)00150-2.
    1. Humpel N, Owen N, Iverson D, Leslie E, Bauman A. Perceived environmental attributes, residential location, and walking for particular purposes. American Journal of Preventive Medicine. 2004;26:119–125. doi: 10.1016/j.amepre.2003.10.005.
    1. Saelens BE, Sallis JF, Black JB, Chen D. Neighbourhood-Based Differences in Physical Activity: An Environmental Scale Evaluation. American Journal of Public Health. 2003;93:1552–1558.
    1. Booth ML, Owen N, Bauman A, Clavisi O, Leslie E. Social-cognitive and perceived environmental influences associated with physical activity in older Australians. Preventive Medicine. 2000;31
    1. Frank LD, Pivo G. Impacts of mixed use and density on utilization of three modes of travel: single-occupant vehicle, transit, and walking. Transportation Research Record. 1994;1466:44–52.
    1. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative research in psychology. 2006;3:77–101. doi: 10.1191/1478088706qp063oa.
    1. Erdfelder E, Faul F, Buchner A. GPOWER: A general power analysis program. . Behavior Research Methods, Instruments, & Computers. 1996;28:1–11.
    1. Cohen J. Statistical power analysis for the behavioral sciences. 2nd. Hillsdale, NJ , Lawrence Earlbaum Associates; 1988.
    1. Park I. Schutz RW "Quick and Easy" Formulae for Approximating Statistical Power in Repeated Measures ANOVA. Measurement in Physical Education and Exercise Science. 1999;3:249–270. doi: 10.1207/s15327841mpee0304_5.
    1. You T, Berman DM, Ryan AS, Nicklas BJ. Effects of Hypocaloric Diet and Exercise Training on Inflammation and Adipocyte Lipolysis in Obese Postmenopausal Women. J Clin Endocrinol Metab. 2004;89:1739–1746. doi: 10.1210/jc.2003-031310.
    1. Kelley GA, Kelley KS, Tran ZV. Walking, lipids and lipoproteins: a meta-analysis of randomized controlled trials. Preventive Medicine. 2004;38:651–661. doi: 10.1016/j.ypmed.2003.12.012.
    1. Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion intervention: The RE-AIM framework. American Journal of Public Health. 1999;89:1323–1327.
    1. Foster C, Hillsdon M, Thorogood M. Interventions for promoting physical activity. Cochrane Database Syst Rev. 2008:CD003180.
    1. Telford A, Salmon S, Jolley D, Crawford D. Reliability and validity of a self-report and proxy-report physical activity questionnaire for children: the Children's Leisure Activities Study Survey. Paediatric Exercise Science. 2004;16:64–78.

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