The purpose of this article is to describe a pedometer-based physical activity intervention (and the research that has been conducted on this program) to provide insight into workable strategies focused on promoting lifestyle physical activity. The First Step Program (FSP) is a facilitated theory-based behavior modification program, originally developed for individuals with type 2 diabetes, that capitalizes on the unique properties of a pedometer to serve as a stimulus for walking and an instrument for individual goal setting, self-monitoring, and feedback. Formative evaluation revealed that participants were highly enthusiastic about the program, and pilot testing demonstrated an immediate and dramatic increase in walking behavior (by approximately 3700 steps/d or 34 minutes of walking per day). A randomized and controlled evaluation produced similar results, as have head-to-head comparisons of participant outcomes produced by professional versus peer delivery, and adaptations of the program to work site and community-based delivery. The effectiveness of the FSP can be explained by a thoughtful consideration of pedometer characteristics, program features, and the people who participate. Sustained delivery is contingent on funding sources and administrative structures that support formalized implementation.
US Department of Health and Human Services.Physical Activity Guidelines for Americans. Rockville, MD: US Department of Health and Human Services ; 2008.
2.
US Department of Health and Human Services.The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. Rockville, MD: US Department of Health and Human Services, Public Health Service, Office of the Surgeon General; 2001.
3.
Troiano RP, Berrigan D., Dodd KW, et al. Physical activity in the United States measured by accelerometer . Med Sci Sports Exerc. 2008;40(1):181-188.
4.
Whaley DE, Haley PPCreating community, assessing need: preparing for a community physical activity intervention. Res Q Exerc Sport. 2008;79(2):245-255.
5.
Reichert FF, Barros AJ, Domingues MR, Hallal PCThe role of perceived personal barriers to engagement in leisure-time physical activity. Am J Public Health. 2007;97(3):515-519.
6.
Dunn AL, Marcus BH, Kampert JB, et al. Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial. JAMA. 1999;281(4):327-334.
7.
Yamanouchi K. , Shinozaki T., Chikada K., et al. Daily walking combined with diet therapy is a useful means for obese NIDDM patients not only to reduce body weight but also to improve insulin sensitivity. Diabetes Care. 1995;18(6):775-778.
8.
Tudor-Locke C., Myers AM, Rodger NW, Ecclestone NATowards acceptable exercise guidelines in type 2 diabetes: an examination of current standards and practices. Can J Diabetes Care. 1998;22:47-53.
9.
Tudor-Locke CE, Bell RC, Meyers AMRevisiting the role of physical activity and exercise in the treatment of type 2 diabetes. Can J Appl Physiol . 2000;25(6):466-492.
10.
Tudor-Locke CE, Myers AM, Rodger NWDevelopment of a theory-based daily activity intervention for individuals with type 2 diabetes. Diabetes Educ. 2001;27(1):85-93.
11.
Bandura A.Social Foundations of Thought and Action: A Social-Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall; 1986.
12.
Prochaska JO , Velicer WFThe transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38-48.
13.
Marlatt GA, Gordon JRRelapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors . New York, NY: Guilford; 1985.
14.
Myers AMProgram Evaluation for Exercise Leaders. Champaign, IL : Human Kinetics; 1999.
15.
Tudor-Locke C.A preliminary study to determine instrument responsiveness to change with a walking program: physical activity logs versus pedometers. Res Q Exerc Sport. 2001;72(3):288-292.
16.
Tudor-Locke CE , Myers AM, Bell RC, Harris SB, Rodger NWPreliminary outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type 2 diabetes. Patient Educ Couns. 2002;47(1):23-28.
17.
Tudor-Locke C. , Myers AM, Rodger NWFormative evaluation of the First Step Program: a practical intervention to increase daily physical activity. Can J Diabetes Care. 2000;47(1):23-28.
18.
Tudor-Locke C., Bell RC, Myers AM, et al. Controlled outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type II diabetes. Int J Obes Relat Metab Disord. 2004;28(1):113-119.
19.
Richardson CR, Newton TL, Abraham JJ, et al. A meta-analysis of pedometer-based walking interventions and weight loss. Ann Fam Med. 2008;6(1):69-77.
20.
Bravata DM, Smith-Spangler C., Sundaram V., et al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA. 2007;298(19): 2296-2304.
21.
Tudor-Locke C., Lauzon N., Myers AM, et al. Effectiveness of the First Step Program delivered by professionals versus peers. J Phys Act Health . In press.
22.
Chan CB, Ryan DA, Tudor-Locke C.Health benefits of a pedometer-based physical activity intervention in sedentary workers. Prev Med. 2004;39(6):1215-1222.
23.
Chan CB, Tudor-Locke C.Real-world evaluation of a community-based pedometer intervention. J Phys Act Health. 2008;5(5):648-664.
24.
Ham SA, Kruger J., Tudor-Locke C.Participation by US adults in sports, exercise, and recreational physical activities. J Phys Act Health. 2009;6:1-10.
25.
Lauzon N., Chan CB, Myers AM, Tudor-Locke C.Participant experiences in a workplace pedometer-based physical activity program . J Phys Act Health. 2008;5(5): 675-687.
26.
Sugden JA, Sniehotta FF, Donnan PT, et al. The feasibility of using pedometers and brief advice to increase activity in sedentary older women-a pilot study. BMC Health Serv Res. 2008;8:169.
27.
Carr LJ, Bartee RT, Dorozynski C., et al. Internet-delivered behavior change program increases physical activity and improves cardiometabolic disease risk factors in sedentary adults: results of a randomized controlled trial. Prev Med. 2008;46(5):431-438.
28.
Faghri PD, Omokaro C., Parker C., et al. E-technology and pedometer walking program to increase physical activity at work. J Prim Prev.2008;29(1):73-91.
29.
Dinger MK, Heesch KC, Cipriani G., Qualls M.Comparison of two email-delivered, pedometer-based interventions to promote walking among insufficiently active women. J Sci Med Sport.2007;10(5):297-302.
30.
Dinger MK, Heesch KC, McClary KRFeasibility of a minimal contact intervention to promote walking among insufficiently active women. Am J Health Promot.2005;20(1):2-6.
31.
Burton NW, Walsh A., Brown WJIt just doesn't speak to me: mid-aged men's reactions to "10,000 Steps a Day."Health Promot J Austr.2008;19(1):52-59.
32.
Tudor-Locke C., Chan CBAn exploratory analysis of adherence patterns and program completion of a pedometer-based physical activity intervention . J Phys Act Health. 2006;3(2):210-220.
33.
Tudor-Locke C., Williams JE, Reis JP, Pluto D.Utility of pedometers for assessing physical activity: convergent validity. Sports Med.2002;32(12):795-808.
34.
Crouter SE, Schneider PL, Bassett DR Jr.Spring-levered versus piezo-electric pedometer accuracy in overweight and obese adults. Med Sci Sports Exerc.2005;37(10):1673-1679.
35.
Swartz AM, Bassett DR Jr, Moore JB, Thompson DL, Strath SJEffects of body mass index on the accuracy of an electronic pedometer. Int J Sports Med.2003;24(8):588-592.
36.
Tudor-Locke C.Manpo-kei: The Art and Science of Step Counting . Victoria, Canada: Trafford; 2003.
