PURPOSE: To (1) compare the effects of two worksite-based walking interventions on employee participation rates; (2) compare average daily step counts between conditions, and; (3) examine the effects of increases in average daily step counts on biometric and psychologic outcomes. DESIGN: We conducted a cluster-randomized trial in which six employer groups were randomly selected and randomly assigned to condition. SETTING: Four manufacturing worksites and two office-based worksite served as the setting. SUBJECTS: A total of 474 employees from six employer groups were included. INTERVENTION: A standard walking program was compared to an enhanced program that included incentives, feedback, competitive challenges, and monthly wellness workshops. MEASURES: Walking was measured by self-reported daily step counts. Survey measures and biometric screenings were administered at baseline and 3, 6, and 9 months after baseline. Analysis: Analysis used linear mixed models with repeated measures. RESULTS: During 9 months, participants in the enhanced condition averaged 726 more steps per day compared with those in the standard condition (p < 0.001). A 1,000-step increase in average daily steps was associated with significant weight loss for both men (-3.8 lbs) and women (-2.1 lbs), and reductions in body mass index (-0.41 men, -0.31 women). Higher step counts were also associated with improvements in mood, having more energy, and higher ratings of overall health. CONCLUSIONS: An enhanced walking program significantly increases participation rates and daily step counts, which were associated with weight loss and reductions in body mass index.

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