Article
A pedometer-based walking intervention supplemented with a counseling component: implementation into primary care clinical practice
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Published: | September 11, 2019 |
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Outline
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Background: General practitioners play a fundamental role in combatting the current epidemic of physical inactivity. Interventions aimed at promoting walking can substantially contribute towards increasing physical activity levels. Pedometers are commonly used within these interventions as effective motivational instruments to increase walking, particularly among older adults and those with multiple chronic diseases such as diabetes.
Objective: The aim of this pilot randomized controlled trial was to evaluate the feasibility and the preliminary efficacy of a pedometer-based walking intervention supplemented with a counseling component in a primary care setting.
Methods: Physically inactive patients were recruited from four general practices and randomized to a 12-week pedometer-based intervention with or without email counseling. Change in daily step count, blood pressure, waist and hip circumference, body mass, anxiety and depression symptoms, and quality of life, as well as patients' adherence and engagement, were assessed to explore the feasibility and the potential efficacy of the intervention.
Results: Thirty-seven patients were recruited and 23 of them were randomized (age 41±10 years, body mass index 32.8±7.3 kg.m2, baseline daily step count 5043±1377 steps). Patients manifested high adherence and actively participated in email communication. Both groups significantly increased their daily step-count (pedometer-plus-counseling +2119, p = 0.002; pedometer-alone +1336, p = 0.03), but the difference between groups was not significant (p = 0.18). When analyzing both groups combined, there was a significant improvement in body mass, waist circumference, systolic blood pressure, anxiety and depression symptoms, and quality of life.
Discussion: Building on this knowledge, a protocol for a definitive large-scale randomized controlled trial in type 2 diabetes patients was developed with the aim to translate the physical activity intervention into routine clinical practice in primary care.
Take home message for practical use: General practitioners are encouraged to promote physical activity among their patients.