Promoting physical activity in a multi-ethnic population at high risk of diabetes: the 48-month PROPELS randomised controlled trial

Abstract

Background Physical activity is associated with a reduced risk of type 2 diabetes and cardiovascular disease but limited evidence exists for the sustained promotion of increased physical activity within diabetes prevention trials. The aim of the study was to investigate the long-term effectiveness of the Walking Away programme, an established group-based behavioural physical activity intervention with pedometer use, when delivered alone or with a supporting mHealth intervention. Methods Those at risk of diabetes (nondiabetic hyperglycaemia) were recruited from primary care, 2013–2015, and randomised to (1) Control (information leaflet); (2) Walking Away (WA), a structured group education session followed by annual group-based support; or (3) Walking Away Plus (WAP), comprising WA annual group-based support and an mHealth intervention delivering tailored text messages supported by telephone calls. Follow-up was conducted at 12 and 48 months. The primary outcome was accelerometer measured ambulatory activity (steps/day). Change in primary outcome was analysed using analysis of covariance with adjustment for baseline, randomisation and stratification variables. Results One thousand three hundred sixty-six individuals were randomised (median age = 61 years, ambulatory activity = 6638 steps/day, women = 49%, ethnic minorities = 28%). Accelerometer data were available for 1017 (74%) individuals at 12 months and 993 (73%) at 48 months. At 12 months, WAP increased their ambulatory activity by 547 (97.5% CI 211, 882) steps/day compared to control and were 1.61 (97.5% CI 1.05, 2.45) times more likely to achieve 150 min/week of moderate-to-vigorous physical activity. Differences were not maintained at 48 months. WA was no different to control at 12 or 48 months. Secondary anthropometric and health outcomes were largely unaltered in both intervention groups apart from small reductions in body weight in WA (~ 1 kg) at 12- and 48-month follow-up. Conclusions Combining a pragmatic group-based intervention with text messaging and telephone support resulted in modest changes to physical activity at 12 months, but changes were not maintained at 48 months. Trial registration ISRCTN 83465245 (registered on 14 June 2012).

The effectiveness of the Structured Health Intervention For Truckers (SHIFT): a cluster randomised controlled trial (RCT)

“…Although the significant differences between groups in activity levels did not persist into the longer-term, it is hard to draw conclusions given that the measurements were taken in the middle of a pandemic that had an impact on people’s working practices and behaviour. Aside from the pandemic, the lack of differences between groups at 16–18 months follow-up is consistent with that seen in other physical activity interventions with longer-term follow-up measures (> 12 months) [ 43 ]. Within HGV drivers, environmental, organisational and policy-level changes (e.g.…”

Association Between Patient Factors and the Effectiveness of Wearable Trackers at Increasing the Number of Steps per Day Among Adults With Cardiometabolic Conditions: Meta-analysis of Individual Patient Data From Randomized Controlled Trials

“…Only 3 studies [37,38,42,43] used a behavior change framework as part of their intervention design, and only 3 studies [36][37][38]43] collected data over the longer term (ie, at least 1 year). Both are clear weaknesses that limit our understanding of sustained effects over time, which is an important gap in knowledge [68]. Differences in tracker functionality may also have significant effects on their performance.…”

Recruitment and characteristics of participants in trials of physical activity for adults aged 45 years and above in general practice: a systematic review

“…Six of the 12 included studies had associated published protocols, which were also read for the purposes of this review. 32–36 , 38 , 39 One study had an associated publication on recruitment 29 ; another was linked to a full online report that included details of recruitment and participant inclusion/exclusion criteria published online. 37 …”

“… 30 Study participants were adults with a mean age range of 50–70 years. Three studies had over 1,000 participants, 36 , 37 , 39 1 had 714, 28 6 had between 100 and 400, 29 , 30 , 32 , 33 , 35 , 38 and 2 had fewer than 100. 31 , 34 …”

“… 28 , 31 , 33 , 34 , 37 A further 3 studies involved only participants with a risk or established diagnosis of a chronic condition associated with low PA levels. 34 , 38 , 39 Six studies reported on chronic health conditions, 29 , 30 , 35–37 , 39 with 2 of these reporting on multimorbidity. 30 , 37 Smoking status was recorded in 5 studies, 28 , 29 , 34 , 35 , 37 with active smokers ranging from 5% to 18%.…”