June 18, 2008 Need a boost to get off the couch? A new study shows that a variety of interventions designed to promote walking can effectively motivate individuals to initiate walking behaviors.
"Walking is the most prevalent and preferred method of physical activity for both work and leisure purposes, making it a prime target for exercise interventions," says lead author David Williams, Ph.D., a psychologist at the Centers for Behavioral and Preventive Medicine at The Miriam Hospital. "Based on our review of studies, walking promotion interventions can be effective in helping people initiate regular walking programs, particularly for those motivated to sign up, and certain aspects of these programs may be more successful than others."
During the study, Williams and his team searched medical research databases and, based on effectiveness, identified 14 randomized controlled trials designed to test interventions specifically targeting walking behavior. The interventions ranged from programs tailored to individual needs to those not personalized and delivered to groups; from mass media campaigns to one-on-one promotions; and motivational messages delivered through the mail, over the phone, and/or in face-to-face meetings.
"Although there have been few well-controlled studies that specifically target walking, results generally show that individuals enrolled in walking interventions were walking significantly more than those in the control groups," says Williams, who is also an assistant professor of psychiatry (research) at The Warren Alpert Medical School of Brown University.
He notes that increased walking on a population level has the potential to significantly decrease the incidence of chronic disease. "While researchers have made great strides in understanding the impact of physical activity on health and wellness, the current challenge is to continue to develop intervention programs that successfully motivate the adoption and maintenance of physical activity," he says.
Additionally, researchers identified studies showing evidence in support of the following intervention strategies:
- Frequency of telephone prompts reminding program participants to continue walking appears to be more important than duration and content of each telephone call.
- Encouraging high frequency walking (five to seven days per week) is more effective in increasing walking than prescribing less frequent (three to five days per week) walking.
- Encouraging walking at a moderate pace is more effective in increasing walking than prescribing high intensity walking.
- Encouraging participants to walk in single bouts or multiple sessions, for example -- 30 minutes at once, or three, 10-minute walks -- were equally effective.
- Mixed results were apparent in studies testing goal-setting in terms of steps per day versus minutes per day; however, results generally support the use of pedometers as a motivational tool.
- Mass media interventions targeting broader audiences, were successful at creating awareness and knowledge about the benefits of walking, but were less successful at impacting individual behavior change without any supplemental intervention.
The authors note that web-based exercise interventions may also be an effective means of promoting physical activity.
"Web-based programs have the potential to make a significant impact. In addition to the popularity and accessibility of the Internet, they have the ability to disseminate individually tailored programs to a broad population in a very cost-effective manner," says Williams.
Subsequent research is needed to find out more about exactly who will benefit from what type of intervention and by how much. "We also need to look at how to incorporate the successful components of interventions into programs that will appeal to people who are not actively seeking out a way to add more physical activity to their lifestyle," says Williams. "That being said, it's encouraging that the interventions we looked at showed promise."
The results of the review are published in the July issue of Medicine & Science in Sports and Exercise.
In addition to Williams, the research team included Charles Matthews, Ph.D., of Vanderbilt University Medical Center; Candace Rutt, Ph.D., of the Centers for Disease Control and Prevention; Melissa Napolitano, Ph.D., of Temple University; and Bess Marcus, Ph.D., of the Centers for Behavioral Medicine at The Miriam Hospital and Alpert Medical School.
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