%0 Journal Article
%T Physical activity levels in adults and older adults 3每4 years after pedometer-based walking interventions: Long-term follow-up of participants from two randomised controlled trials in UK primary care
%A Cathy McKay
%A Charlotte Wahlich
%A Cheryl Furness
%A Christina R. Victor
%A Derek G. Cook
%A Elizabeth S. Limb
%A Judith Ibison
%A Julia Fox-Rushby
%A Michael Ussher
%A Peter H. Whincup
%A Sally M. Kerry
%A Stephen DeWilde
%A Steve Iliffe
%A Tess Harris
%A Ulf Ekelund
%J PLOS Medicine: A Peer-Reviewed Open-Access Journal
%D 2018
%R https://doi.org/10.1371/journal.pmed.1002526
%X Physical inactivity is an important cause of noncommunicable diseases. Interventions can increase short-term physical activity (PA), but health benefits require maintenance. Few interventions have evaluated PA objectively beyond 12 months. We followed up two pedometer interventions with positive 12-month effects to examine objective PA levels at 3每4 years. Long-term follow-up of two completed trials: Pedometer And Consultation Evaluation-UP (PACE-UP) 3-arm (postal, nurse support, control) at 3 years and Pedometer Accelerometer Consultation Evaluation-Lift (PACE-Lift) 2-arm (nurse support, control) at 4 years post-baseline. Randomly selected patients from 10 United Kingdom primary care practices were recruited (PACE-UP: 45每75 years, PACE-Lift: 60每75 years). Intervention arms received 12-week walking programmes (pedometer, handbooks, PA diaries) postally (PACE-UP) or with nurse support (PACE-UP, PACE-Lift). Main outcomes were changes in 7-day accelerometer average daily step counts and weekly time in moderate-to-vigorous PA (MVPA) in ≡10-minute bouts in intervention versus control groups, between baseline and 3 years (PACE-UP) and 4 years (PACE-Lift). PACE-UP 3-year follow-up was 67% (681/1,023) (mean age: 59, 64% female), and PACE-Lift 4-year follow-up was 76% (225/298) (mean age: 67, 53% female). PACE-UP 3-year intervention versus control comparisons were as follows: additional steps/day postal +627 (95% CI: 198每1,056), p = 0.004, nurse +670 (95% CI: 237每1,102), p = 0.002; total weekly MVPA in bouts (minutes/week) postal +28 (95% CI: 7每49), p = 0.009, nurse +24 (95% CI: 3每45), p = 0.03. PACE-Lift 4-year intervention versus control comparisons were: +407 (95% CI: ˋ177每992), p = 0.17 steps/day, and +32 (95% CI: 5每60), p = 0.02 minutes/week MVPA in bouts. Neither trial showed sedentary or wear-time differences. Main study limitation was incomplete follow-up; however, results were robust to missing data sensitivity analyses. Intervention participants followed up from both trials demonstrated higher levels of objectively measured PA at 3每4 years than controls, similar to previously reported 12-month trial effects. Pedometer interventions, delivered by post or with nurse support, can help address the public health physical inactivity challenge. PACE-UP isrctn.com ISRCTN98538934; PACE-Lift isrctn.com ISRCTN42122561.
%U https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002526