10.17863/CAM.48872
Hardeman, Wendy
0000-0002-6498-9407
Mitchell, Joanna
0000-0003-2138-3402
Pears, Sally
0000-0002-6417-1402
Van Emmenis, Miranda
Theil, Florence
Gc, Vijay S
0000-0003-0365-2605
Vasconcelos, Joana C
0000-0001-7709-4058
Westgate, Kate
0000-0002-0283-3562
Brage, Søren
0000-0002-1265-7355
Suhrcke, Marc
0000-0001-7263-8626
Griffin, Simon J
0000-0002-2157-4797
Kinmonth, Ann Louise
Wilson, Edward CF
0000-0002-8369-1577
Prevost, A Toby
0000-0003-1723-0796
Sutton, Stephen
VBI Research Team
Evaluation of a very brief pedometer-based physical activity intervention delivered in NHS Health Checks in England: The VBI randomised controlled trial.
Public Library of Science (PLoS)
2020
Actigraphy
Adult
Aged
Cost-Benefit Analysis
England
Exercise
Female
Fitness Trackers
Health Care Costs
Healthy Lifestyle
Healthy Volunteers
Humans
Male
Middle Aged
Primary Health Care
State Medicine
Time Factors
Apollo - University of Cambridge Repository
University of Cambridge
013meh722
2020-02-07
2020-02-07
2020-03
eng
Article
https://www.repository.cam.ac.uk/handle/1810/301803
10.1371/journal.pmed.1003046
All rights reserved
open.access
BACKGROUND: The majority of people do not achieve recommended levels of physical activity. There is a need for effective, scalable interventions to promote activity. Self-monitoring by pedometer is a potentially suitable strategy. We assessed the effectiveness and cost-effectiveness of a very brief (5-minute) pedometer-based intervention ('Step It Up') delivered as part of National Health Service (NHS) Health Checks in primary care. METHODS AND FINDINGS: The Very Brief Intervention (VBI) Trial was a two parallel-group, randomised controlled trial (RCT) with 3-month follow-up, conducted in 23 primary care practices in the East of England. Participants were 1,007 healthy adults aged 40 to 74 years eligible for an NHS Health Check. They were randomly allocated (1:1) using a web-based tool between October 1, 2014, and December 31, 2015, to either intervention (505) or control group (502), stratified by primary care practice. Participants were aware of study group allocation. Control participants received the NHS Health Check only. Intervention participants additionally received Step It Up: a 5-minute face-to-face discussion, written materials, pedometer, and step chart. The primary outcome was accelerometer-based physical activity volume at 3-month follow-up adjusted for sex, 5-year age group, and general practice. Secondary outcomes included time spent in different intensities of physical activity, self-reported physical activity, and economic measures. We conducted an in-depth fidelity assessment on a subsample of Health Check consultations. Participants' mean age was 56 years, two-thirds were female, they were predominantly white, and two-thirds were in paid employment. The primary outcome was available in 859 (85.3%) participants. There was no significant between-group difference in activity volume at 3 months (adjusted intervention effect 8.8 counts per minute [cpm]; 95% CI -18.7 to 36.3; p = 0.53). We found no significant between-group differences in the secondary outcomes of step counts per day, time spent in moderate or vigorous activity, time spent in vigorous activity, and time spent in moderate-intensity activity (accelerometer-derived variables); as well as in total physical activity, home-based activity, work-based activity, leisure-based activity, commuting physical activity, and screen or TV time (self-reported physical activity variables). Of the 505 intervention participants, 491 (97%) received the Step it Up intervention. Analysis of 37 intervention consultations showed that 60% of Step it Up components were delivered faithfully. The intervention cost £18.04 per participant. Incremental cost to the NHS per 1,000-step increase per day was £96 and to society was £239. Adverse events were reported by 5 intervention participants (of which 2 were serious) and 5 control participants (of which 2 were serious). The study's limitations include a participation rate of 16% and low return of audiotapes by practices for fidelity assessment. CONCLUSIONS: In this large well-conducted trial, we found no evidence of effect of a plausible very brief pedometer intervention embedded in NHS Health Checks on objectively measured activity at 3-month follow-up. TRIAL REGISTRATION: Current Controlled Trials (ISRCTN72691150).
Medical Research Council
MC_UU_12015/3
Department of Health (via National Institute for Health Research (NIHR))
NF-SI-0515-10119
Medical Research Council
MC_UU_12015/4
CCF
Medical Research Council
MC_U106179474
MRC
MC_UU_00006/4
National Institute for Health and Care Research
IS-BRC-1215-20014