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OP81 Long-term objective physical activity data from two primary care pedometer-based randomised controlled trials in middle-aged and older adults– are there still positive trial effects at 3 and 4 years?
  1. E Limb1,
  2. T Harris1,
  3. S Kerry2,
  4. C Victor3,
  5. S Iliffe4,
  6. M Ussher1,
  7. P Whincup1,
  8. C Furness1,
  9. C Wahlich1,
  10. D Cook1,
  11. U Ekelund5,
  12. J Fox-Rushby6,
  13. J Ibison1,
  14. S DeWilde1
  1. 1Population Health Research Institute, St George’s University of London, London, UK
  2. 2Pragmatic Clinical Trials Unit, Queen Mary’s University of London, London, UK
  3. 3Gerontology and Health Services Research Unit, Brunel, University of London, London, UK
  4. 4Research Department of Primary Care and Population Health, University College of London, London, UK
  5. 5Department of Sports Science, Oslo University, Norway
  6. 6Health Economics Research group, Brunel, University of London, UK


Background The PACE-UP 3-armed primary care trial recruited 45–75 year olds into a 12 week pedometer-based intervention, with one postal intervention arm and one nurse support. The PACE-Lift 2-armed primary care trial recruited 60–75 year olds into a 12 week nurse-supported pedometer-based intervention. Both trials increased step-counts by around a tenth and time in moderate-to-vigorous physical activity (MVPA) in bouts by around a third at 12 months, with no difference between nurse and postal arms in PACE-UP. Long-term physical activity (PA) maintenance, particularly MVPA in bouts, is important for a wide range of health benefits, but few trials provide objective PA measures beyond 12 months. We followed up PACE-UP and PACE-Lift cohorts at 3 and 4 years respectively, to investigate whether intervention effects persisted.

Methods 3 year (PACE-UP) and 4 year (PACE-Lift) accelerometer outcomes were regressed on baseline accelerometry to estimate change in average daily step-counts and average weekly time in MVPA in ≥10 min bouts in the treatment groups compared to control groups. Imputation analyses were conducted to account for missing data effects.

Results PACE-UP 3 year follow-up rate was 67% (681/1023). Both intervention groups were still doing more steps/day than the control group: postal 627 (95% CI 198, 1056); nurse 670 (95% CI 237, 1102); nurse plus postal 648 (95% CI 272, 1024). The pattern was similar for total weekly MVPA in bouts: postal 28 (95% CI 7, 49); nurse 24 (95% CI 24 (3, 45); nurse plus postal 26 (95% CI 8, 44). PACE-Lift 4 year follow-up rate was 76% (225/298). In PACE-Lift the intervention versus control comparisons were 407 (95% CI −177, 992) for steps and 32 (95% CI 5, 60) for MVPA in bouts; though the steps comparison is not statistically significant, both the steps and MVPA estimates are consistent with the PACE-UP findings. Both trials showed no wear-time differences between groups and imputation analyses did not change results interpretation.

Conclusion Over two thirds of both trial cohorts provided long-term data. Both trials showed persistent effects on time in MVPA in bouts at 3 or 4 years. PACE-UP showed a significant persistent effect on step-counts and no difference between nurse and postal group outcomes. In PACE-Lift the step-count effect, while not statistically significant was consistent with both the PACE-UP findings and with the persistent significant effect for MVPA in bouts in PACE-Lift. These findings suggest that primary care pedometer interventions, delivered by post or with minimal contact, can make an important long-term contribution to addressing the public health physical inactivity challenge.

  • physical activity RCT follow-up

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