The use of pedometers and the '10.000 steps/day'-concept in the promotion of physical activity

Despite the fact that physical activity has been promoted previously, a considerable amount of adults still do not meet the current health-related physical activity guideline of 30 minutes of moderate to vigorous physical activity per day. However, an inactive lifestyle is related to inverse health outcomes, consequently, effective physical activity interventions are needed. Recent interventions used step counters or pedometers, mostly in combination with step count goals, to encourage physical activity. In general, the pedometer was found to be an effective intervention tool in the United States, Australia, and Japan. However, no European data on physical activity promotion through pedometer use and step count goals are available. Also information about methodological aspects of pedometer use is missing in Europe. Therefore, the current thesis presents pedometer-related methodological research and pedometer-based intervention studies in Flanders, Belgium (Europe). The first methodological study evaluated the validity of an inexpensive pedometer. Results showed that the „Stepping Meter‟ was unacceptable for research and practice, as it gave invalid information. Two other methodological studies found significant correlations between pedometer-determined step counts and self-reported physical activity, and showed that a valid pedometer is capable of assessing not only walking, but also moderate and vigorous physical activity in different contexts. Pedometer-based interventions were implemented on the micro-, meso-, and macro-level and showed promising results. It was found that a 3-week individual-based intervention consisting of pedometer use, with or without cognitive and behavioural support materials, increased physical activity in motivated individuals. In this study, support materials, such as an information brochure, and a log to set goals and record steps, had an additional positive effect on attitudes towards pedometer use. A workplace pedometer-based intervention was effective in reducing the decrease in step counts, probably caused by winter time, in already active employees. Two effectiveness studies of the community campaign “10,000 Steps Ghent” showed a high project awareness level, a decrease in sitting time, and an increase in physical activity among both active and inactive individuals. An additional study found that pedometer use was more likely in older participants and in those aware of the campaign. Increased step counts were more likely among higher educated individuals, at-risk persons (baseline step counts below 10,000 steps/day) and those who used a pedometer. Furthermore, it was found that pedometer use partly mediated the intervention effect on step counts

Digital health interventions in everyday settings

Digitalisation, the use of digital technologies and platforms such as computers, websites, smartphones, and wearable devices, is everywhere in many ways [...

From evidence-based research to practice-based evidence : disseminating a web-based computer-tailored workplace sitting intervention through a health promotion organisation

Prolonged sitting has been linked to adverse health outcomes; therefore, we developed and examined a web-based, computer-tailored workplace sitting intervention. As we had previously shown good effectiveness, the next stage was to conduct a dissemination study. This study reports on the dissemination efforts of a health promotion organisation, associated costs, reach achieved, and attributes of the website users. The organisation systematically registered all the time and resources invested to promote the intervention. Website usage statistics (reach) and descriptive statistics (website users' attributes) were also assessed. Online strategies (promotion on their homepage; sending e-mails, newsletters, Twitter, Facebook and LinkedIn posts to professional partners) were the main dissemination methods. The total time investment was 25.6 h, which cost approximately 845 EUR in salaries. After sixteen months, 1599 adults had visited the website and 1500 (93.8%) completed the survey to receive personalized sitting advice. This sample was 38.3 +/- 11.0 years, mainly female (76.9%), college/university educated (89.0%), highly sedentary (88.5% sat >8 h/day) and intending to change (93.0%) their sitting. Given the small time and money investment, these outcomes are positive and indicate the potential for wide-scale dissemination. However, more efforts are needed to reach men, non-college/university educated employees, and those not intending behavioural change

Moderators and mediators of pedometer use and step count increase in the "10,000 Steps Ghent" intervention

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

Cross-sectional associations between home environmental factors and domain-specific sedentary behaviors in adults: the moderating role of socio-demographic variables and BMI

Despite the negative health effects of too much sitting, the majority of adults are too sedentary. To develop effective interventions, insight is needed into home environmental correlates of adults’ sedentary behaviors, and into the susceptibility of population subgroups to these home environmental cues. In total, 559 Flemish adults reported socio-demographics, weight and height, home environmental factors and domain-specific sedentary behaviors. Generalized linear modeling was conducted to examine main associations between home environmental factors and domain-specific sedentary behaviors, and to test the moderating role of socio-demographics and BMI on these associations. In case of significant interactions, stratified analyses were performed. Results showed that, among those who did use a computer/laptop during the last week, a one-unit increase in the number of computers or laptops was associated with 17% (OR = 1.17; 95% CI = 1.02, 1.34) and 24% (OR = 1.24; 95% CI = 1.08, 1.43) more minutes computer time per day, respectively. The proximity of the remote controller (p < 0.001) and the number of televisions (p = 0.03) were positively associated with television time, and the number of motorized vehicles (95% CI = 0.001, 0.12) was positively associated with the odds of participation in transport-related sitting time. The latter two associations were moderated by BMI, with significant positive associations limited to those not overweight. To conclude, home environmental factors were associated with domain-specific sedentary behaviors, especially in healthy weight adults. If confirmed by longitudinal studies, public health professionals should encourage adults to limit the number of indoor entertainment devices and motorized vehicles

What do pedometer counts represent? A comparison between pedometer data and data from four different questionnaires

OBJECTIVES: To compare physical activity (PA) reported through pedometer registrations (step counts) with PA reported in four different questionnaires; to compare step count thresholds (7,500, 10,000 and 12,500 steps/d) with the PA guideline of 30 min of moderate to vigorous PA (MVPA) per day. SUBJECTS: A sample of 310 healthy adults, mean age 38.7 (sd 11.9) years, volunteered to participate. Forty-seven per cent was male and 93 % of the sample was employed. METHODS: PA was assessed by interview (Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ)), three self-administered questionnaires (long version and short version of the International Physical Activity Questionnaire (long-form IPAQ, short-form IPAQ), Baecke questionnaire) and seven consecutive days of pedometer registration. RESULTS: Step counts correlated positively with questionnaire-based PA. The strongest correlations were found between step counts and total PA reported in the long-form IPAQ (rs = 0.37), moderate PA reported in the short-form IPAQ (rs = 0.33), total and moderate PA reported in the MLTPAQ (rs = 0.32), and the total and leisure-time PA indices (excluding sport) reported in the Baecke questionnaire (rs = 0.44). According to step counts, 22.6 % of the participants were somewhat active, 18.7 % active and 39.4 % highly active. As assessed by the long-form IPAQ, short-form IPAQ and MLTPAQ, the guideline of 30 min MVPA/d was reached by respectively 85.4 %, 84.8 % and 68.0 % of participants. CONCLUSION: Pedometer-based data offer adequate information to discriminate between levels of PA. Caution is needed when comparing active samples based on different PA recommendations

Socio-demographic, psychosocial and home-environmental attributes associated with adults' domestic screen time.

BACKGROUND: Sedentary behaviors (involving prolonged sitting time) are associated with deleterious health consequences, independent of (lack of) physical activity. To inform interventions, correlates of prevalent sedentary behaviors need to be identified. We examined associations of socio-demographic, home-environmental and psychosocial factors with adults' TV viewing time and leisure-time Internet use; and whether psychosocial and environmental correlates differed according to gender, age and educational attainment. METHODS: This cross-sectional study was conducted in Ghent, Belgium, between March and May 2010. Respondents to a mail-out survey (n = 419; 20-65 years; mean age 48.5 [12.1] years; 47.3% men) completed a questionnaire on sedentary behaviors and their potential socio-demographic, psychosocial and home environmental correlates. Statistical analyses were performed using multiple linear regression models. RESULTS: The independent variables explained 31% of the variance in TV viewing time and 38% of the variance in leisure-time Internet use. Higher education, greater perceived pros of and confidence about reducing TV time were negatively associated with TV viewing time; older age, higher body mass index, larger TV set size and greater perceived cons of reducing TV time showed positive associations. Perceived pros of and confidence about reducing Internet use were negatively associated with leisure-time Internet use; higher education, number of computers in the home, positive family social norms about Internet use and perceived cons of reducing Internet use showed positive associations. None of the socio-demographic factors moderated these associations. CONCLUSIONS: Educational level, age, self-efficacy and pros/cons were the most important correlates identified in this study. If further cross-sectional and longitudinal research can confirm these findings, tailored interventions focusing on both psychosocial and environmental factors in specific population subgroups might be most effective to reduce domestic screen time.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Differences in context-specific sedentary behaviors according to weight status in adolescents, adults and seniors: a compositional data analysis

To develop effective sedentary behavior interventions aimed at people who are overweight/obese, detailed insight is needed into the contexts of sedentary behavior of these people. Therefore, the aims of this study were to describe the composition of sedentary behavior and to compare context-specific sedentary behaviors between different weight groups. Cross-sectional data were used from a study conducted in 2013-2014 among a Flemish sample of adolescents (n = 513), adults (n = 301), and seniors (n = 258). Sixteen context-specific sedentary behaviors were assessed using a validated questionnaire during the week and weekend. Compositional descriptive statistics were performed to determine the relative contribution of context-specific sedentary behaviors in the three age groups. Compositional multivariate analysis of covariance and pairwise comparisons were conducted to examine weight group differences in context-specific sedentary behaviors. The compositional means indicated that the highest proportion of sedentary time was spent at school, at work, and while watching television. Statistically significant differences were found in the composition of sedentary behaviors between healthy weight and overweight/obese participants. In all age groups, socially engaging sedentary behaviors were more prevalent in healthy weight people, whereas socially disengaging behaviors were more prevalent in overweight/obese people. Consequently, the findings of this study suggest that future overweight/obesity interventions should no longer focus on total sedentary time, as not all context-specific sedentary behaviors are associated with overweight/obesity. Instead, it might be better to target specific contexts of sedentary behaviorspreferably those less socially engagingwhen aiming to reduce overweight/obesity

Educational inequalities in TV viewing among older adults: a mediation analysis of ecological factors

BACKGROUND: Television (TV) viewing, a prevalent leisure-time sedentary behaviour independently related to negative health outcomes, appears to be higher in less educated and older adults. In order to tackle the social inequalities, evidence is needed about the underlying mechanisms of the association between education and TV viewing. The present purpose was to examine the potential mediating role of personal, social and physical environmental factors in the relationship between education and TV viewing among Australian 55-65 year-old adults. METHODS: In 2010, self-reported data was collected among 4082 adults (47.6% men) across urban and rural areas of Victoria, for the Wellbeing, Eating and Exercise for a Long Life (WELL) study. The mediating role of personal (body mass index [BMI], quality of life), social (social support from family and friends, social participation at proximal level, and interpersonal trust, social cohesion, personal safety at distal level) and physical environmental (neighbourhood aesthetics, neighbourhood physical activity environment, number of televisions) factors in the association between education and TV viewing time was examined using the product-of-coefficients test of MacKinnon based on multilevel linear regression analyses (conducted in 2012). RESULTS: Multiple mediating analyses showed that BMI (p </= 0.01), personal safety (p < 0.001), neighbourhood aesthetics (p </= 0.01) and number of televisions (p </= 0.01) partly explained the educational inequalities in older adult's TV viewing. No proximal social factors mediated the education-TV viewing association. CONCLUSIONS: Interventions aimed to reduce TV viewing should focus on personal (BMI) and environmental (personal safety, neighbourhood aesthetics, number of televisions) factors, in order to overcome educational inequalities in sedentary behaviour among older adults