A simple low cost Doctor DELivered PHysical activity Intervention

Plain English Summary

Background and study aims
In recent years there have been significant reductions in walking and cycling for transport that has not been replaced by increases in recreational activity, so the population has become more inactive and rates of obesity have increased. Increasing physical activity in the population is most likely to be achieved by reversing the trend of reductions in walking. Walking can easily be undertaken at sufficient intensity for health gain and can be integrated more easily into daily life than more formal exercise. To be beneficial to health, physical activity should be performed at a moderate intensity which for most people is equivalent to walking at a brisk or fast pace (approximately 5.6 to 6.4 km/hour). Although 77% of adults walk for at least 30 minutes once a month, only 32% do so at a self reported brisk/fast pace. It is likely that advice to increase the frequency and intensity (pace) of walking will be more acceptable than advice to take up new, less common activities. Studies have shown that advising people to walk a fixed distance at a brisk pace, leads to moderate intensity walking speeds and improvements in established cardiovascular disease risk factors and fitness. A simple message such as ‘walk a mile at a brisk pace’ can lead to self-selected walking paces that are of sufficient intensity to produce benefits, but still low enough to be safe. Although volunteers can follow simple walking messages in controlled settings, it is uncertain whether people would adopt and adhere to messages if they were delivered opportunistically (while they are waiting for routine appointments with a GP) by a GP, to inactive people who were not seeking advice. Simple walking messages requiring little or no explanation can be delivered quickly and are therefore suitable for time pressured settings such as general practice. General practitioners (GPs) understand the importance of physical activity and are enthusiastic about giving advice but frequently cite lack of time as the main barrier to doing so. If it was shown that a simple screening system and easy to deliver physical activity message was a cost-effective way to reduce inactivity, then it is likely that adoption by GPs could be achieved. A recent review of pedometer interventions shows that pedometer users significantly increase their physical activity, especially if set a target number of steps per pay. Therefore, we propose to examine the feasibility of conducting a trial comparing usual care, usual care plus simple advice, and usual care plus simple advice and use of a pedometer, to reduce the number of inactive patients.

Who can participate?
Any male or female aged 40-74 years who can walk for 5 minutes continuously without undue fatigue or discomfort and who is registered with one of the participating practices.

What does the study involve?
Twenty four general practices (8 each in Devon, Bristol and Coventry) will be recruited. Half of the practices will recruit patients opportunistically (while they are waiting for routine appointments with a GP) and half will recruit patients by written invitation if they are registered at the practice and in the age group 40-74 years.
All consenting participants will be randomly allocated to one of three treatment groups.
Two methods of allocation will be tested: i) randomisation at the level of the practice (all patients from the same practice will be randomised to the same arm of one of the three arms of the study) and ii) randomisation of individual patients within practices (patients within the same practice will be randomised to one of the three study arms).
Participants allocated to the control arm (Arm A) will be given: (i)written information on physical activity and its benefits;(ii) a pedometer (which will be sealed so that participants cannot view the readings during the intervention) and written information on how to use it.
(Arm B), participants will receive the same items and information as for Arm A but will also be advised by their GP to “walk at least a mile per day (15–20 minutes) at a brisk to fast pace, each day of the week.”
(Arm C) , participants will receive the same items, written physical activity information and verbal advice as in Arm B. However, for arm C, the pedometer will unsealed (allowing them the view the readings showing the number of steps taken) and participants will be given written information about how to use it. All patients will complete a questionnaire at baseline and 12 weeks post randomisation.

Where is the study run from?
The study is coordinated from the University of Exeter but also involves Bristol and Warwick University.

When is the study starting and how long is it expected to run for?
The study will ran from June 2010 to September 2011

Who is funding the study?
The National Prevention Research Initiative managed by the Medical Research Council

Who is the main contact?
Associate Professor Melvyn Hillsdon

Study website

Contact information

Study information

Eligibility

Locations

Countries of recruitment

• England
• United Kingdom

Study participating centre

Sponsor information

University of Exeter (UK)
University/education

c/o Helen Loughlin
Head of Research Policy
Research and Knowledge Transfer
Stocker Road
Exeter
EX4 4PY
England
United Kingdom

Website	http://www.exeter.ac.uk/
"ROR"	https://ror.org/03yghzc09

Funders

Funder type

Research council

Results and Publications

Study outputs