7 research outputs found
The HealtheStepsâą lifestyle prescription program to improve physical activity and modifiable risk factors for chronic disease: a pragmatic randomized controlled trial.
BACKGROUND: Our objective was to determine the influence of the HealtheStepsâą lifestyle prescription program on physical activity and modifiable risk factors for chronic disease in individuals at risk.
METHODS: One hundred eighteen participants were recruited from 5 sites in Southwestern Ontario, Canada and randomized to either the intervention (HealtheStepsâą program, nâ=â59) or a wait-list control group (nâ=â59). The study comprised three phases: an Active Phase (0 to 6âmonths) consisted of bi-monthly in-person lifestyle coaching with access to a suite of eHealth technology supports (Heathesteps app, telephone coaching and a private HealtheStepsâą social network) followed by a Minimally-Supported Phase I (6 to 12âmonths), in which in-person coaching was removed, but participants still had access to the full suite of eHealth technology supports. In the final stage, Minimally-Supported Phase II (12 to 18âmonths), access to the eHealth technology supports was restricted to the HealtheStepsâą app. Assessments were conducted at baseline, 6, 12 and 18âmonths. The study primary outcome was the 6-month change in average number of steps per day. Secondary outcomes included: self-reported physical activity and sedentary time; self-reported eating habits; weight and body composition measures; blood pressure and health-related quality of life. Data from all participants were analyzed using an intent-to-treat approach. We applied mixed effects models for repeated measurements and adjusted for age, sex, and site in the statistical analyses.
RESULTS: Participants in HealtheStepsâą increased step counts (between-group [95% confidence interval]: 3132 [1969 to 4294], pâ\u3câ0.001), decreased their sitting time (-â0.08 [-â0.16 to -â0.006], pâ=â0.03), and improved their overall healthful eating (-â1.5 [-â2.42 to -â0.58], pâ=â0.002) to a greater extent compared to control at 6âmonths. Furthermore, exploratory results showed that these individuals maintained these outcomes 12âmonths later, after a minimally-supported phase; and retained improvements in sedentary time and improved healthful eating after 18âmonths. No differences in self-reported physical activity, health-related quality of life, weight, waist circumference or blood pressure were observed between groups at 6âmonths.
CONCLUSIONS: Our findings suggest that HealtheStepsâą is effective at increasing physical activity (i.e., step counts per day), decreasing weekday sitting time, and improving healthful eating in adults at increased risk for chronic disease after 6âmonths; however, we did not see change in other risk factors. Nonetheless, the maintenance of these behaviours with minimal support after 12 and even 18âmonths indicates the promise of HealtheStepsâą for long-term sustainability.
TRIAL REGISTRATION: The trial was registered on April 6, 2015 with ClinicalTrials.gov (identifier: NCT02413385 )