How many days of pedometer monitoring predict monthly ambulatory activity in adults?

PURPOSE: To determine how many days of pedometer monitoring are necessary to estimate monthly ambulatory activity in adults. METHODS: 212 adults (64% female, age=38.3±13.3 years, BMI=27.9±5.3 kg/m2) wore a pedometer (SW-200) for 28 consecutive days. 76.4% were randomly allocated to a reliability group while the remainder (n = 50) comprised a confirmation group. Mean step counts calculated over the 28-day period served as the criterion. Using the reliability group, intra-class correlations (ICCs) were computed for the entire 4 week period, for 3, 2 and 1 weeks, and for different combinations of any 6, 5, 4, 3 and 2 days. The reliability of the recommended time frame was tested in the confirmation group using regression analysis. RESULTS: In the reliability group, the ICC for any single given day was 0.41. All combinations including 6 days or more had ICCs above 0.80. The inclusion of participant characteristics into a regression, alongside mean steps reported during 1 week of monitoring, failed to strengthen the prediction. When tested in the confirmation group, there was a significant relationship between mean step counts calculated from the first week of monitoring and the criterion (adjusted R2 =0.91, CONCLUSION: It is recommended that researchers collect pedometer data over a 7-day period for a reliable estimate of monthly activity in adults. A 7-day period is recommended, as opposed to 6 days (where ICCs were >0.80) because: 1) step counts are characteristically lower on a Sunday, thus for a reliable estimate of habitual activity, Sunday activity should always be included, and 2) in the event of missing data (1 day), data collected on six days will remain sufficiently reliable to estimate mean monthly activity

Research with and for Older People at Loughborough University

Our Dementia research is part of Loughborough University Health and Wellbeing (HWB) Global Challenge http://www.lboro.ac.uk/research/excellence/challenges/health-wellbeing/). This strategic approach supports multi-disciplinary research in bringing complex real world solutions to promote health and wellbeing across the life course. Other research priorities within HWB include Planetary Health and Anti-Microbial Resistance. Research with and for older people in Loughborough University is carried out by a number of multi-disciplinary research units/groups with different specialist interests for example: - Dementia research for design, diagnostics and interventions http://www.lboro.ac.uk/research/dementia/ - Centre for Research in Social Policy (http://www.lboro.ac.uk/research/crsp/) - Healthcare Ergonomics & Patient Safety (http://www.lboro.ac.uk/departments/design-school/research/environmentalergonomics/) - Life Long determinants of health and wellbeing (http://www.lboro.ac.uk/departments/ssehs/research/lifestyle-healthwellbeing/life-course-determinants-health-wellbeing/) We describe our research in these five overlapping and closely-related topic areas: (1) New Dynamics of Ageing; (2) Dementia: Diagnosis, Design and Interventions; (3) Getting out and about (Transport ); (4) Working Later; (5) Health, Wellbeing and Safety for Older Peopl

A critical discussion of the Community Readiness Model using a case study of childhood obesity prevention in England

Recent reforms to the public health system in England aim to generate co-ordinated action between local authorities, healthcare systems and communities to target local health priorities. To support this effort, researchers must contribute and evaluate appropriate strategies for designing interventions tailored to community-specific needs. One strategy is to apply the Community Readiness Model (CRM), which uses key informant interviews to assess a community's readiness to address local issues. This article presents a critical discussion of the CRM developed from a case study of obesity prevention in pre-adolescent girls within a community in the United Kingdom. Data were collected between February and November 2011. We offer lessons learnt and recommendations relating to (i) modifications to the interview guide; (ii) key informant identification; (iii) conducting interviews to theoretical saturation; (iv) using key informants to define their community; (v) key informant's ability to respond on behalf of the community; (vi) using a qualitative model with a quantitative scoring system; and (vii) the optimum application of transcript scoring. In conclusion, the CRM can help researchers, health professionals and local authorities identify the priorities of a community. It is recommended that users of the model be careful to identify and recruit suitable key informants with the help of the community under study, select an appropriate ‘community’ and utilise the qualitative findings to strengthen the interpretation of the readiness score

Summer to winter variability in the step counts of normal weight and overweight adults living in the UK

BACKGROUND: This study investigated whether pedometer-determined activity varies between summer and winter in normal-weight and overweight adults. METHODS: Forty-five normal-weight (58% female, age = 39.1 ± 12.4 years, BMI = 22.2 ± 2.1 kg/m2) and 51 overweight (49% female, age = 42.1 ± 12.5 years, BMI = 29.3 ± 4.5 kg/m2) participants completed a within-subject biseasonal pedometer study. All participants completed 2 4-week monitoring periods; 1 period in the summer and 1 period the following winter. Changes in step counts across seasons were calculated and compared for the 2 BMI groups. RESULTS: Both BMI groups reported significant summer to winter reductions in step counts, with the magnitude of change being significantly greater in the normal-weight group (–1737 ± 2201 versus –781 ± 1673 steps/day, P = .02). Winter step counts did not differ significantly between the 2 groups (9250 ± 2845 versus 8974 ± 2709 steps/day, P = .63), whereas the normal-weight group reported a significantly higher mean daily step count in the summer (10986 ± 2858 versus 9755 ± 2874 steps/day, P = .04). CONCLUSION: Both normal-weight and overweight individuals experienced a reduction in step counts between summer and winter; however, normal-weight individuals appear more susceptible to winter decreases in ambulatory activity, with the greatest seasonal change occurring on Sundays. Effective physical activity policies should be seasonally tailored to provide opportunities to encourage individuals to be more active during the winter, particularly on weekends

UK adults exhibit higher step counts in summer compared to winter months

Background: Seasonal differences in step counts have been observed in a limited number of studies conducted on US adults. Due to the diverse global climate, assessment and interpretation of seasonal patterns in ambulatory activity may vary between countries, and regionally specific studies are necessary to understand global patterns. Currently, no studies have assessed whether a seasonal trend is present when ambulatory activity is measured objectively in adults living in the UK. Aim: To investigate whether pedometer-determined step counts of adults living in the UK vary between summer and winter. Subjects and methods: Ninety-six adults (52% male, age = 41.0 ± 12.3 years, BMI = 26.1 ± 5.1 kg/m2) completed a within-subject bi-seasonal pedometer study. All participants completed two four-week monitoring periods; one during the summer and one the following winter. The same Yamax SW-200 pedometer was worn throughout waking hours during both seasons, and daily step counts were recorded in an activity log. Intra-individual seasonal changes in mean daily steps were analysed using a paired samples t-test. Results: Summer mean daily step counts (10417 ± 3055 steps/day) were significantly higher than those reported during the winter (9132 ± 2841 steps/day) (p < 0.001). A follow-up study conducted the subsequent summer in a sub-sample (n = 28) reinforced this trend. Summer step counts were significantly higher than winter step counts on all days of the week (p ≤ 0.001). A significant day of the week effect was present in both seasons, with step counts reported on a Sunday being on average 1,500 steps/day lower than those reported Monday through to Saturday. Conclusion: Step counts in the sample of UK adults surveyed decreased significantly in the winter compared to the summer, suggesting future pedometer surveillance studies should capture step counts throughout the year for a non-biased reflection of habitual ambulatory activity. Public health initiatives should target these seasonal differences and opportunities should be provided which encourage individuals to increase their activity levels during the colder, darker months of the year

Firefighting to innovation: using human factors and ergonomics to tackle slip, trip, and fall risks in hospitals

Objective: The aim of this study was to use a theoretical model (bench) for human factors and ergonomics (HFE) and a comparison with occupational slips, trips, and falls (STFs) risk management to discuss patient STF interventions (bedside). Background: Risk factors for patient STFs have been identified and reported since the 1950s and are mostly unchanged in the 2010s. The prevailing clinical view has been that STF events indicate underlying frailty or illness, and so many of the interventions over the past 60 years have focused on assessing and treating physiological factors (dizziness, illness, vision/hearing, medicines) rather than designing interventions to reduce risk factors at the time of the STF. Method: Three case studies are used to discuss how HFE has been, or could be, applied to STF risk management as (a) a design-based (building) approach to embed safety into the built environment, (b) a staff- (and organization-) based approach, and (c) a patient behavior–based approach to explore and understand patient perspectives of STF events. Results and Conclusion: The results from the case studies suggest taking a similar HFE integration approach to other industries, that is, a sustainable design intervention for the person who experiences the STF event—the patient. Application: This paper offers a proactive problem-solving approach to reduce STFs by patients in acute hospitals. Authors of the three case studies use HFE principles (bench/book) to understand the complex systems for facility and equipment design and include the perspective of all stakeholders (bedside)

Evaluation of a commercially available pedometer used to promote physical activity as part of a national programme

Objective: To assess the accuracy of a pedometer (manufactured by Silva) currently being used as part of a national programme to promote physical activity in the UK. Methods: Laboratory study: 68 participants (age 19.2±2.7 years, BMI 22.5±3.3 kg/m2) wore 2 Silva pedometers (over the right and left hips) whilst walking on a motorised treadmill at 2, 2.5, 3, 3.5 and 4mph. Pedometer step counts were compared with actual steps counted. Free-living study: 134 participants (age 36.4±18.1 years, BMI 26.3±5.1 kg/m2) wore one Silva pedometer, one New-Lifestyles NL-1000 pedometer and an ActiGraph GT1M accelerometer (the criterion) during waking hours for one day. Step counts registered by the Silva and NL- 1000 pedometers were compared to ActiGraph step counts. Percent error of the pedometers were compared across normal-weight (n=58), overweight (n=45) and obese (n=31) participants. Results: Laboratory study: Across the speeds tested percent error in steps ranged from 6.7 (4mph) – 46.9% (2mph). Free-living study: Overall percent errors of the Silva and NL-1000 pedometers relative to the criterion were 36.3% and 9% respectively. Significant differences in percent error of the Silva pedometer were observed across BMI groups (normal-weight 21%, overweight 40.2%, obese 59.2%, P<0.001). Conclusion: The findings suggest the Silva pedometer is unacceptably inaccurate for activity promotion purposes particularly in overweight and obese adults. Pedometers are an excellent tool for activity promotion however the use of inexpensive, untested pedometers is not recommended as they will lead to user frustration, low intervention compliance, and adverse reaction to the instrument, potentially impacting future public health campaigns

Sitting time and step counts in office workers

BACKGROUND: Technological advances mean that many adults are now employed in sedentary occupations. Given evidence linking prolonged sitting to chronic disease risk, understanding sitting and physical activity in and outside the workplace may usefully inform effective interventions. AIMS: To assess sitting time and physical activity during and outside working hours in fulltime office workers. METHODS: Participants wore a pedometer and recorded sitting times and step counts during and outside working hours for seven days. Participants were divided into tertiles based on the proportion of time spent sitting at work. Sitting times and step counts reported outside work were compared between groups, using one-way analysis of variance. RESULTS: There were 72 participants. Almost two thirds (65%) of time at work was spent sitting. The sample accumulated 3742±2493 steps at work and 5159±2474 steps outside work on workdays. Participants in the highest tertile for workplace sitting reported sitting for longer than those in the lowest tertile during transport (64±59 vs 21±16 mins), after-work (154±30 vs 126±51mins) and at weekends (382±133 vs 288±124mins, all p<0.05). Work duration and steps reported outside work did not differ between groups. CONCLUSIONS: Office workers who sit for a large proportion of their working day also report sitting for longer outside work. They do not compensate for their sedentary behaviour at work by being more active outside work. Occupational health interventions should focus on reducing workplace and leisure-time sitting in sedentary office workers

Urban South African adolescents' perceptions of their neighborhood socio-economic environments: the Birth to Twenty plus cohort study

The Apartheid era led to major differences in the living conditions between population groups in South Africa. Subsequently, reforms have been implemented to reduce poverty and inequalities. This study aims to assess neighborhood and school socio-economic (SE) environments reported by adolescents to determine whether geographic and population group differences in the SE environment exist. Neighborhood SE status was assessed using a novel questionnaire adapted to the urban South African context. Black African and Mixed Ancestry participants lived in more deprived SE environments and reported studying in less favorable school environments compared to Whites. Among Black Africans, those living in Soweto versus metropolitan Johannesburg reported more deprived economic and school environments

Sitting time and obesity in a sample of adults from Europe and the USA

Obesity is a risk factor for many chronic diseases and the prevalence is increasing worldwide. Research suggests that sedentary behaviour (sitting) may be related to obesity.To examine the association between sitting time and obesity, while controlling for physical activity, in a large international sample.5338 adults from the UK, USA, Germany, Spain, Italy, France, Portugal, Austria and Switzerland self-reported their total daily sitting time, physical activity, age, height and weight. BMI (kg/m(2)), total physical activity (MET-minutes/week) and sitting time (hours/day) were derived. Participants were grouped into quartiles based on their daily sitting time (8 hours/day) and logistic regression models explored the odds of being obese versus normal weight for each sitting time quartile.Participants in the highest sitting time quartile (≥8 hours/day) had 62% higher odds of obesity compared to participants in the lowest quartile (<4 hours/day) after adjustment for physical activity and other confounding variables (OR = 1.62, 95% CI = 1.24-2.12, p<0.01).Sitting time is associated with obesity in adults, independent of physical activity. Future research should clarify this association using objective measures of sitting time and physical activity to further inform health guidelines