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Health promotion in older Chinese: a 12-month cluster randomized controlled trial of pedometry and peer support
Thomas GN, Macfarlane DJ, Guo B, Cheung BMY, McGhee SM, Chou K-L, Deeks JJ, Lam TH, Tomlinson B
Medicine and Science in Sports and Exercise 2012 Jun;44(6):1157-1166
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: Aging, in conjunction with decreasing physical activity, is associated with a range of health problems. Simple, low-maintenance, population-based means of promoting activity to counteract the age-associated decline are required. We therefore assessed the effect of pedometry and buddy support to increase physical activity. METHODS: We undertook a clustered randomized trial (HKCTR-346) of 24 community centers involving 399 older Chinese participants (60 yr). Centers were randomly allocated to (1) pedometry and buddy, (2) pedometry and no buddy, (3) no pedometry and buddy, and (4) no pedometry and no buddy with a 2x2 factorial design. The trial simultaneously tested the individual and combined effects of the interventions. The intervention groups also received monthly organized group activities to provide encouragement and support. Outcome measures were assessed at 6 and 12 months, including physical fitness and activity and cardiovascular disease risk factors (anthropometry and blood pressure). RESULTS: From the 24 centers, 356 volunteers (89.2%) completed the study. Those receiving the interventions had higher mean physical activity levels at 12 months of 1,820 (95% confidence interval (CI) 1,360 to 2,290) and 1,260 (95% CI 780 to 1,740) MET/min/wk, respectively relative to the decrease in the control groups. The buddy peer support intervention significantly improved mean aerobic fitness (12% (95% CI 4% to 21%)) and reduced both body fat (-0.6% (95% CI -1.1% to 0.0%)) and time to complete the 2.5-m get-up-and-go test (-0.27 (95% CI -0.53 to -0.01) s). No other improvements in the cardiovascular disease risk factors were observed. The combination of motivational tools was no better than the individual interventions. CONCLUSIONS: Both motivational interventions increased physical activity levels, and the buddy style improved fitness. These tools could be useful adjuncts in the prevention of obesity and age-related complications.

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