Web-Based Plan Got the Sedentary Up Walking

Major Finding: Patients referred to an Internet-based program increased the minutes spent in aerobic walking from 27 minutes at baseline to 72 minutes at 6 weeks.

Data Source: A pilot cohort study involving six pairs of family medicine providers and 37 sedentary patients who were overweight, had coronary artery disease, and/or had diabetes.

Disclosures: One of the study's coinvestigators is a consultant to Omron Healthcare, which manufactures the pedometers used in the walking program.

SEATTLE — An Internet-based program increased walking to a clinically meaningful level among sedentary patients with comorbidities in a pilot study of the primary care–based intervention.

The 37 patients in the study—all of whom were overweight, had coronary artery disease, and/or had diabetes—increased their total daily step count by 1.3-fold and their total daily aerobic step count by 2.7-fold, reported David Goodrich, Ed.D., of the University of Michigan in Ann Arbor.

By the end of the 6-week program, the patients were logging 72 minutes of aerobic walking each week on average, up from just 27 minutes at baseline.

“That's half the duration of our Surgeon General's recommendation,” Dr. Goodrich noted.

Few primary care interventions have been effective for promoting physical activity among patients with comorbidities, he said. “Physicians are often uncomfortable counseling patients because of time constraints, they have liability concerns if an accident were to occur while a patient were exercising (such as a heart attack), they are not trained in exercise prescription, and there is a lack of interventions that they can use that are time and cost effective,” he explained.

The walking program, called Stepping Up to Health, targets people with or at risk for chronic disease and encourages them to use pedometers that upload data to the Internet.

The investigators conducted a study to develop and test a clinical interface that would facilitate referral of patients to the program by primary care providers and allow them to monitor the patients' progress and safety.

Six pairs of family physicians and medical assistants participated in developing the Web site, which had a referral page, displayed patients' walking goals and actual step counts from the pedometers, and documented any exercise-related adverse events. The site was then tested among the providers during routine clinical care.

To be eligible, patients had to be sedentary and overweight, have coronary artery disease and/or type 2 diabetes, use the Internet, and be sufficiently motivated.

Of 139 patients referred to the program, 37 (27%) enrolled; they had a mean age of 45 years. The majority were female (65%), white (92%), and had at least some college education (92%). In terms of comorbidities, 97% of the patients were obese, 22% had diabetes, and 8% had coronary artery disease.

“There was a clinically significant increase in steps,” he reported, with patients increasing their average number of steps per day by 1.3-fold (from 4,520 to 6,013), average number of aerobic steps per day by 2.7-fold (from 406 to 1,114), and number of minutes of aerobic walking per week by 2.7-fold (from 27 to 72).

Most of the patients who completed a satisfaction survey agreed or strongly agreed that the program was useful (94%), increased the amount they walked (85%), was easy to use (94%), and that they liked working with it (88%).

Many providers said that if the program had interfaced with electronic medical records, there would have been more prompting to use it, he noted. Also, physicians perceived the referral process to be burdensome and to add a competing priority.

Major Finding: Patients referred to an Internet-based program increased the minutes spent in aerobic walking from 27 minutes at baseline to 72 minutes at 6 weeks.

Data Source: A pilot cohort study involving six pairs of family medicine providers and 37 sedentary patients who were overweight, had coronary artery disease, and/or had diabetes.

Disclosures: One of the study's coinvestigators is a consultant to Omron Healthcare, which manufactures the pedometers used in the walking program.

SEATTLE — An Internet-based program increased walking to a clinically meaningful level among sedentary patients with comorbidities in a pilot study of the primary care–based intervention.

The 37 patients in the study—all of whom were overweight, had coronary artery disease, and/or had diabetes—increased their total daily step count by 1.3-fold and their total daily aerobic step count by 2.7-fold, reported David Goodrich, Ed.D., of the University of Michigan in Ann Arbor.

By the end of the 6-week program, the patients were logging 72 minutes of aerobic walking each week on average, up from just 27 minutes at baseline.

“That's half the duration of our Surgeon General's recommendation,” Dr. Goodrich noted.

Few primary care interventions have been effective for promoting physical activity among patients with comorbidities, he said. “Physicians are often uncomfortable counseling patients because of time constraints, they have liability concerns if an accident were to occur while a patient were exercising (such as a heart attack), they are not trained in exercise prescription, and there is a lack of interventions that they can use that are time and cost effective,” he explained.

The walking program, called Stepping Up to Health, targets people with or at risk for chronic disease and encourages them to use pedometers that upload data to the Internet.

The investigators conducted a study to develop and test a clinical interface that would facilitate referral of patients to the program by primary care providers and allow them to monitor the patients' progress and safety.

Six pairs of family physicians and medical assistants participated in developing the Web site, which had a referral page, displayed patients' walking goals and actual step counts from the pedometers, and documented any exercise-related adverse events. The site was then tested among the providers during routine clinical care.

To be eligible, patients had to be sedentary and overweight, have coronary artery disease and/or type 2 diabetes, use the Internet, and be sufficiently motivated.

Of 139 patients referred to the program, 37 (27%) enrolled; they had a mean age of 45 years. The majority were female (65%), white (92%), and had at least some college education (92%). In terms of comorbidities, 97% of the patients were obese, 22% had diabetes, and 8% had coronary artery disease.

“There was a clinically significant increase in steps,” he reported, with patients increasing their average number of steps per day by 1.3-fold (from 4,520 to 6,013), average number of aerobic steps per day by 2.7-fold (from 406 to 1,114), and number of minutes of aerobic walking per week by 2.7-fold (from 27 to 72).

Most of the patients who completed a satisfaction survey agreed or strongly agreed that the program was useful (94%), increased the amount they walked (85%), was easy to use (94%), and that they liked working with it (88%).

Many providers said that if the program had interfaced with electronic medical records, there would have been more prompting to use it, he noted. Also, physicians perceived the referral process to be burdensome and to add a competing priority.

Major Finding: Patients referred to an Internet-based program increased the minutes spent in aerobic walking from 27 minutes at baseline to 72 minutes at 6 weeks.

Data Source: A pilot cohort study involving six pairs of family medicine providers and 37 sedentary patients who were overweight, had coronary artery disease, and/or had diabetes.

Disclosures: One of the study's coinvestigators is a consultant to Omron Healthcare, which manufactures the pedometers used in the walking program.

SEATTLE — An Internet-based program increased walking to a clinically meaningful level among sedentary patients with comorbidities in a pilot study of the primary care–based intervention.

The 37 patients in the study—all of whom were overweight, had coronary artery disease, and/or had diabetes—increased their total daily step count by 1.3-fold and their total daily aerobic step count by 2.7-fold, reported David Goodrich, Ed.D., of the University of Michigan in Ann Arbor.

By the end of the 6-week program, the patients were logging 72 minutes of aerobic walking each week on average, up from just 27 minutes at baseline.

“That's half the duration of our Surgeon General's recommendation,” Dr. Goodrich noted.

Few primary care interventions have been effective for promoting physical activity among patients with comorbidities, he said. “Physicians are often uncomfortable counseling patients because of time constraints, they have liability concerns if an accident were to occur while a patient were exercising (such as a heart attack), they are not trained in exercise prescription, and there is a lack of interventions that they can use that are time and cost effective,” he explained.

The walking program, called Stepping Up to Health, targets people with or at risk for chronic disease and encourages them to use pedometers that upload data to the Internet.

The investigators conducted a study to develop and test a clinical interface that would facilitate referral of patients to the program by primary care providers and allow them to monitor the patients' progress and safety.

Six pairs of family physicians and medical assistants participated in developing the Web site, which had a referral page, displayed patients' walking goals and actual step counts from the pedometers, and documented any exercise-related adverse events. The site was then tested among the providers during routine clinical care.

To be eligible, patients had to be sedentary and overweight, have coronary artery disease and/or type 2 diabetes, use the Internet, and be sufficiently motivated.

Of 139 patients referred to the program, 37 (27%) enrolled; they had a mean age of 45 years. The majority were female (65%), white (92%), and had at least some college education (92%). In terms of comorbidities, 97% of the patients were obese, 22% had diabetes, and 8% had coronary artery disease.

“There was a clinically significant increase in steps,” he reported, with patients increasing their average number of steps per day by 1.3-fold (from 4,520 to 6,013), average number of aerobic steps per day by 2.7-fold (from 406 to 1,114), and number of minutes of aerobic walking per week by 2.7-fold (from 27 to 72).

Most of the patients who completed a satisfaction survey agreed or strongly agreed that the program was useful (94%), increased the amount they walked (85%), was easy to use (94%), and that they liked working with it (88%).

Many providers said that if the program had interfaced with electronic medical records, there would have been more prompting to use it, he noted. Also, physicians perceived the referral process to be burdensome and to add a competing priority.