Step Tracking with Goals Increases Children's Weight Loss in Behavioral Intervention.
ABSTRACT: This study examined the influence of step goals with pedometers to improve children's weight loss, physical activity, and psychosocial health during obesity treatment.Overweight and obese children ages 8-17 years (n?=?105) participated in a 10-week family-based weight management intervention, including physical activity, nutrition, and behavioral modification. A quasi-experimental design was used to group eight cohorts into three conditions: no pedometer (n?=?24), pedometer only (n?=?25), and pedometer with step goals (i.e., 500 steps/day weekly increase above baseline; n?=?56). Height and weight were measured at baseline and week 10 and used to calculate BMI. Analysis of covariance was performed to examine difference by condition for change in weight, BMI, and BMI z-score, controlling for age and baseline value. Differences in steps per day and psychosocial health were compared between the two pedometer conditions.Participants were 12.4?±?2.5 years of age, including 70% girls and 64% African Americans. The pedometer with goals condition significantly reduced BMI (p?=?0.02) and BMI z-score (p?=?0.01) compared with the no-pedometer group. The pedometer with goals condition significantly increased steps per day (+1185?±?425 steps/day) compared with the pedometer-only condition (-162?±?620 steps/day; p?
Project description:Walking programs improve health outcomes in adults at risk for cardiovascular disease and self-monitoring strategies can improve adherence to such programs. The objective of this study was to determine if a six-month internet-based walking program using web-enhanced pedometers results in more weight loss than walking programs based on time or simple pedometer-step count goals in adults with or at risk for cardiovascular disease (CVD).This was a multi-site, randomized controlled trial of 255 male Veterans who were ambulatory, insufficiently active, BMI ? 28, and who reported 1 ? CVD risk factors. Participants were randomized to one of three self-monitoring strategies to increase walking: (1) time-based walking goals; (2) simple pedometer-based walking goals; and (3) web-enhanced pedometer feedback goals with Internet-mediated feedback. All participants also attended five individual weight loss sessions with a dietitian. The main outcome measure was change in weight at six months (kg) and secondary outcomes were change in accelerometer-measured physical activity (min) and change in health-related quality of life at six months.The 255 participants had a mean age of 56.3 years (SD = 10.0), BMI=36.3 (SD = 5.3) with a mean of 5.2 (SD = 2.3) medical comorbidities. Dropouts were distributed evenly across the three groups and 72% of participants completed the program. At six months, participants in the web-enhanced pedometer arm lost significantly more weight (-1.9 kg, 95% CI=-2.7, -1.1) than those in the time-based group (-0.7 kg, 95% CI=-1.5, 0.0; p = 0.04) and simple pedometer group (-0.6 kg, 95% CI=-1.4, 0.2; p = 0.02).Internet-enhanced pedometers result in greater weight loss in Veterans than walking programs using time-based walking goals or simple pedometers.
Project description:BACKGROUND:The purpose of this study was to: 1) evaluate the quality of promotional pedometers widely distributed through cereal boxes at the time of the 2004 Canada on the Move campaign; and 2) establish a battery of testing protocols to provide direction for future consensus on industry standards for pedometer quality. METHODS:Fifteen Kellogg's* Special K* Step Counters (K pedometers or K; manufactured for Kellogg Canada by Sasco, Inc.) and 9 Yamax pedometers (Yamax; Yamax Corporation, Tokyo, Japan) were tested with 9 participants accordingly: 1) 20 Step Test; 2) treadmill at 80m x min(-1) (3 miles x hr(-1)) and motor vehicle controlled conditions; and 3) 24-hour free-living conditions against an accelerometer criterion. RESULTS:Fifty-three percent of the K pedometers passed the 20 Step Test compared to 100% of the Yamax. Mean absolute percent error for the K during treadmill walking was 24.2+/-33.9 vs. 3.9+/-6.6% for the Yamax. The K detected 5.7-fold more non-steps compared to the Yamax during the motor vehicle condition. In the free-living condition, mean absolute percent error relative to the ActiGraph was 44.9+/-34.5% for the K vs. 19.5+/-21.2% for the Yamax. CONCLUSIONS:K pedometers are unacceptably inaccurate. We suggest that research grade pedometers: 1) be manufactured to a sensitivity threshold of 0.35 Gs; 2) detect +/-1 step error on the 20 Step Test (i.e., within 5%); 3) detect +/-1% error most of the time during treadmill walking at 80m x min(-1) (3 miles x hr(-1)); as well as, 4) detect steps/day within 10% of the ActiGraph at least 60% of the time, or be within 10% of the Yamax under free-living conditions.
Project description:This study examined the reliability of two objective measurement tools in assessing children’s physical activity (PA) levels in an exergaming setting.A total of 377 children (190 girls, Mage = 8.39, SD = 1.55) attended the 30-min exergaming class every other day for 18 weeks. Children’s PA levels were concurrently measured by NL-1000 pedometer and ActiGraph GT3X accelerometer, while children’s steps per min and time engaged in sedentary, light, and moderate-to-vigorous PA were estimated, respectively.The results of intraclass correlation coefficient (ICC) indicated a low degree of reliability (single measures ICC = 0.03) in accelerometers. ANOVA did detect a possible learning effect for 27 classes (p < 0.01), and the single measures ICC was 0.20 for pedometers. Moreover, there was no significant positive relationship between steps per min and time spent in moderate-to-vigorous physical activity (MVPA). Finally, only 1.3% variance was explained by pedometer as a predictor using Hierarchical Linear Modeling to further explore the relationship between pedometer and accelerometer data.The NL-1000 pedometers and ActiGraph GT3X accelerometers have low reliability in assessing elementary school children’s PA levels during exergaming. More research is warranted in determining the reliable and accurate measurement information regarding the use of modern devices in exergaming setting.
Project description:OBJECTIVE:To assess whether pedometers and text messaging increase physical activity in adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS:A 12-week randomized controlled trial was conducted. A total of 78 subjects participated in the trial (mean +/- SD age 14.4 +/- 2.37 years, 36 [47%] male). Intervention participants wore an open pedometer and received regular motivational text messages. Control participants received usual care. Primary outcomes were daily step count (4-day closed pedometer) and physical activity questionnaire. RESULTS:Baseline median step count was 11,063 steps/day (range 1,541-20,158). At 12 weeks, mean daily step count reduced by 840 (95% CI -1,947 to 266) in the control group and by 22 (-1,407 to 1,364) in the intervention group (P = 0.4). Mean self-reported moderate or vigorous physical activity increased by 38.5 min/week in the control group and by 48.4 in the intervention group (P = 0.9). CONCLUSIONS:A 12-week intervention using pedometers and text messaging as motivational tools in adolescents with type 1 diabetes did not increase physical activity.
Project description:Although pedometer intervention is effective in increasing physical activity among adults with Type 2 diabetes, its impact on weight loss remains unclear. This meta-analysis was aimed to assess whether pedometer intervention promotes weight loss.Three different databases were searched for randomized controlled trials (RCTs) published in English up to April 2015. Studies were included if they investigated the effects of pedometer intervention on weight loss, as measured by BMI or weight. Effect sizes were aggregated using a random-effects model. Subgroup and meta-regression analyses were used to identify potential moderators. Eleven RCTs with 1258 participants were included. All enrolled participants were overweight or obese.Pedometer intervention led to significantly decreased BMI [weighted mean difference (WMD) -0.15 kg/m(2) , 95% confidence interval (CI) -0.29 to -0.02 kg/m(2) ] and reduced weight (WMD -0.65 kg, 95% CI -1.12 to -0.17 kg). Dietary counselling seemed to be a key predictor of the observed changes. However, none of the following variables had a significant influence: step goal setting, baseline age, BMI, weight, sex distribution, disease duration, intervention duration, and baseline values or change scores for total or moderate-to-vigorous physical activity. After completion of the pedometer intervention, non-significant declines in BMI and weight were observed during the follow-up periods.Pedometer intervention promotes modest weight loss, but its association with physical activity requires further clarification. Future studies are also required to document dietary and sedentary behaviour changes to facilitate the use of pedometers for weight loss in overweight and obese adults with Type 2 diabetes.
Project description:The purpose of this review is to update expected values for pedometer-determined physical activity in free-living healthy older populations. A search of the literature published since 2001 began with a keyword (pedometer, "step counter," "step activity monitor" or "accelerometer AND steps/day") search of PubMed, Cumulative Index to Nursing & Allied Health Literature (CINAHL), SportDiscus, and PsychInfo. An iterative process was then undertaken to abstract and verify studies of pedometer-determined physical activity (captured in terms of steps taken; distance only was not accepted) in free-living adult populations described as >/= 50 years of age (studies that included samples which spanned this threshold were not included unless they provided at least some appropriately age-stratified data) and not specifically recruited based on any chronic disease or disability. We identified 28 studies representing at least 1,343 males and 3,098 females ranging in age from 50-94 years. Eighteen (or 64%) of the studies clearly identified using a Yamax pedometer model. Monitoring frames ranged from 3 days to 1 year; the modal length of time was 7 days (17 studies, or 61%). Mean pedometer-determined physical activity ranged from 2,015 steps/day to 8,938 steps/day. In those studies reporting such data, consistent patterns emerged: males generally took more steps/day than similarly aged females, steps/day decreased across study-specific age groupings, and BMI-defined normal weight individuals took more steps/day than overweight/obese older adults. The range of 2,000-9,000 steps/day likely reflects the true variability of physical activity behaviors in older populations. More explicit patterns, for example sex- and age-specific relationships, remain to be informed by future research endeavors.
Project description:BACKGROUND:Physical activity decreases from childhood through adulthood. Among youth, teenagers (teens) achieve the lowest levels of physical activity, and high school age youth are particularly at risk of inactivity. Effective methods are needed to increase youth physical activity in a way that can be maintained through adulthood. Because teens text a great deal, text messages promoting walking, a low cost physical activity, may be an effective method for promoting sustainable physical activity. OBJECTIVE:The objective of our study was to determine the effect of pedometers, self selected step goals, and texts grounded in the self-determination theory (SDT) on physical activity among the teens. METHODS:"TXT Me!" was a 12 week intervention that texted 14-17 year olds to increase their daily physical activity by increasing the number of steps they take each day. The intervention was grounded in the SDT. Formative research with the teens helped construct the intervention and develop the texts. A total of 84 texts were developed (12 to set a step goal, and 72 promoting autonomy, competence, and relatedness). The pilot evaluation used a four group, randomized design (n=160). After baseline data collection, the participants were randomized to one of four conditions (no treatment control, pedometer only, pedometer + weekly prompts, pedometer + weekly prompts + SDT grounded texts). Data were collected at baseline and immediately upon completion of the study. The primary outcome was physical activity, measured by 7 days of accelerometry. Basic psychological needs, physical activity motivation, process evaluation, and program satisfaction data were also collected. RESULTS:To our knowledge, this is one of the first studies to explore the use of stand alone, SDT grounded texts, supported by pedometers and prompts to set a self selected step goal, as a method for increasing physical activity among teens. CONCLUSIONS:This pilot study will contribute valuable information regarding whether theoretically grounded text messages show promise as an effective method to increase physical activity among teens. TRIAL REGISTRATION:Clinicaltrials.gov NCT01482234; http://clinicaltrials.gov/ct2/show/NCT01482234 (Archived by WebCite at http://www.webcitation.org/6NYvRMOoq).
Project description:OBJECTIVE To investigate whether a pragmatic structured education program with and without pedometer use is effective for promoting physical activity and improving glucose tolerance in those with impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS Overweight and obese individuals with IGT were recruited from ongoing screening studies at the University Hospitals of Leicester, U.K. Participants were randomly assigned to one of three groups. Group 1 received a 3-h group-based structured education program designed to promote walking activity using personalized steps-per-day goals and pedometers. Group 2 received a 3-h group-based structured education program designed to promote walking activity using generic time-based goals. Group 3 received a brief information leaflet (control condition). Outcomes included an oral glucose tolerance test, standard anthropometric measures, ambulatory activity, and psychological variables. Follow-up was conducted at 3, 6, and 12 months. RESULTS A total of 87 individuals (66% male, mean age 65 years) were included in this study. At 12 months, significant decreases in 2-h postchallenge glucose and fasting glucose of -1.31 mmol/l (95% CI -2.20 to -0.43) and -0.32 mmol/l (-0.59 to -0.03), respectively, were seen in the pedometer group compared with the control group. No significant improvements in glucose control were seen in those given the standard education program. CONCLUSIONS This study suggests that a pragmatic structured education program that incorporates pedometer use is effective for improving glucose tolerance in those with IGT. This result is likely to have important implications for future primary care-based diabetes prevention initiatives.
Project description:BACKGROUND:A randomized trial of a pedometer-based intervention with weekly activity goals led to a modest increase in step count among dialysis patients. In a secondary analysis, we investigated the effect of this intervention on body composition. METHODS:Sixty dialysis patients were randomized to standard care or a 6-month program consisting of 3?months of pedometers and weekly step count targets and 3?months of post-intervention follow-up. We obtained bioelectrical impedance spectroscopy (BIS) data on 54 of these patients (28 control, 26 intervention) and used linear mixed-modeling (adjusted for sex and dialysis modality) to estimate differences in change in total-body muscle mass (TBMM) adjusted for height2, fat mass (kg), and body mass index (BMI) (kg/m2) between control and intervention groups. RESULTS:The median age of participants was 57.5?years (53-66), and 76% were men. At baseline, there was no significant difference between groups in age, BMI, race, or body composition, but there were more men in the intervention group. After 3?months, patients in the intervention group increased their average daily steps by 2414 (95% CI 1047, 3782) more than controls (p <?0.001), but there were no significant differences in body composition. However, at 6?months, participants in the intervention had a significantly greater increase from baseline in TBMM of 0.7?kg/m2 (95% CI 0.3, 1.13), decrease in fat mass (-?4.3?kg [95% CI -7.1, -?1.5]) and decrease in BMI (-?1.0?kg/m2 [95% CI -1.8, -?0.2]) relative to controls. In post-hoc analysis, each increase of 1000 steps from 0 to 3?months was associated with a 0.3?kg decrease in fat mass (95% CI 0.05, 0.5) from 0 to 6?months, but there was no dose-response relationship with TBMM/ht2 or BMI. CONCLUSION:A pedometer-based intervention resulted in greater decreases in fat mass with relative preservation of muscle mass, leading to a greater decrease in BMI over time compared with patients not in the intervention. These differences were driven as much by worsening in the control group as by improvement in the intervention group. Step counts had a dose-response relationship with decrease in fat mass. TRIAL REGISTRATION:ClinicalTrials.gov (NCT02623348). 02 December 2015.
Project description:BACKGROUND: The European pedometer-based "10,000 Steps Ghent" whole community intervention for 228,000 residents was found to be effective in increasing step counts by an average of 896 steps/day in a sub-sample of adults. The present study aimed to examine the characteristics of intervention participants (n = 438) who (1) used a pedometer and (2) increased their step counts. Additionally, the third aim was to examine the mediational effect of pedometer use on step count change. METHODS: The study sample consisted of 438 adults (207 male, mean age 49.8 (13.1) years). Binary logistic regressions were used to examine whether individual characteristics (gender, age, educational level, employment status, self-reported health condition, baseline step counts, baseline sitting time, baseline transport-related PA) and intervention exposure variables (having heard/seen a PA promotion message, being aware of the PA guidelines, and knowing about "10,000 Steps Ghent") were associated with (1) pedometer use and (2) a step count increase of 896 steps/day or more. Using pooled data (n = 864) from the intervention and comparison participants, a mediation analysis was conducted to see if the change in step counts was mediated by pedometer use. RESULTS: Age (49 years or more: OR = 3.19, p < 0.005), awareness of a PA promotion message (OR = 2.62, p < 0.01) and awareness of "10,000 Steps Ghent" (OR = 2.11, p < 0.05) were significantly associated with pedometer use. Participants with a college or university degree (OR = 1.55, p < 0.05) and those who used a pedometer (OR = 2.06, p < 0.05) were more likely to increase their steps by 896 steps/day or more. This increase was less likely among those with baseline step counts above 10,000 steps/day (OR = 0.38, p < 0.001). The mediation analysis revealed that pedometer use partly mediated step count change. CONCLUSION: Pedometer use was more likely in older participants and in those who were aware of the "10,000 Steps" campaign. Increasing step counts was more likely among those with higher education, baseline step counts below 10,000 steps/day and those who used a pedometer. Pedometer use only partly mediated the intervention effect on step counts.