In a study published in the Translational Journal of the American College of Sports Medicine, Caroline R. Richardson, MD, the Dr. Max and Buena Lichter Research Professor and Associate Chair for Research Programs, and colleagues, conducted a multisite, three-arm randomized controlled trial to compare the effectiveness of three low-cost walking programs that were combined with dietary counseling to promote weight loss and reduce the risk of cardiovascular disease. The study targeted male veterans at risk for cardiovascular disease, with 255 total participants, averaging 56 years old. Participants were randomized to one of three pragmatic walking intervention arms, and all participants simultaneously underwent five face-to-face dietary counseling sessions with a dietician during the six-month trial.
Arm 1: Manual log book with time-based walking goals
Arm 2: Simple pedometer with step count goals
Arm 3: Web-enhanced pedometer with data upload capabilities, paired with web-based step count feedback and goals
The study compared change in weight from baseline to end-of-trial, as well as change in physical activity, measured using an accelerometer worn for one week during all waking hours. Physical activity was defined as the average number of minutes per day of physical activity. The study measured potential mediating variables, like comorbidities and computer literacy, using baseline and end-of-trial surveys.
The study found that at 6 months, participants in the Web-enhanced pedometer group lost significantly more weight (−1.9 kg, 95% CI, −2.7 to −1.1) compared to the manual log book (−0.7 kg, 95% CI, −1.5 to 0.0; P = 0.04) and simple pedometer (−0.6 kg, 95% CI, −1.4 to 0.2; P = 0.02) users. The study's results support the use of Internet-enhanced pedometers as a scalable and low cost compliment to "existing brief dietary counseling interventions for weight loss and CVD risk reduction."
The authors note that "this trial is unique because it was designed to answer a fundamental question of how different modes of self-monitoring ambulatory activity in a high-risk population enhance clinical outcomes."
Full article citation: Richardson CR, Goodrich DE, Larkin AR, Ronis D, Holleman RG, Damschroder LJ, Lowery JC. A comparative effectiveness trial of three walking self-monitoring strategies. Transl J Am Coll Sports Med in press. DOI: 10.1249/TJX.0000000000000017
