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Open Access Research article

'Pedometers cost buttons': the feasibility of implementing a pedometer based walking programme within the community

Rebecca Shaw1*, Elisabeth Fenwick2, Graham Baker3, Chloe McAdam3, Claire Fitzsimons3 and Nanette Mutrie3

Author Affiliations

1 School of Medicine, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK

2 Health Economics and Health Technology Assessment, Centre for Population & Health Sciences, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK

3 School of Psychological Sciences and Health, University of Strathclyde, Jordanhill Campus, 76 Southbrae Drive, Glasgow G13 1PP, UK

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BMC Public Health 2011, 11:200  doi:10.1186/1471-2458-11-200

Published: 31 March 2011

Abstract

Background

Recent studies have suggested that walking interventions may be effective (at least in the short term) at increasing physical activity amongst those people who are the most inactive. This is a leading objective of contemporary public health policy in the UK and worldwide. However, before committing money from limited budgets to implement walking interventions more widely in the community, policymakers will want to know whether similar impacts can be expected and whether any changes will be required to the process to ensure uptake and success. This paper utilises the findings from a recent community-based pedometer study (Walking for Wellbeing in the West - WWW) undertaken in Glasgow, Scotland to address issues of feasibility.

Methods

An economic analysis of the WWW study assessed the costs of the interventions (minimal and maximal) and combined these with the effects to present incremental cost-effectiveness ratios (cost/person achieving the target of an additional 15,000 steps/week). A qualitative evaluation, involving focus group discussions with WWW participants and short interviews with members of the WWW research team, explored perceived benefits and barriers associated with walking, as well as the successful aspects and challenges associated with the interventions.

Results

The incremental cost effectiveness associated with the interventions was estimated as £92 and £591 per person achieving the target for the minimal and maximal interventions respectively. The qualitative evaluation gave insight into the process by which the results were achieved, and identified several barriers and facilitators that would need to be addressed before implementing the interventions in the wider community, in order to ensure their effective transfer. These included assessing the impact of the relationship between researchers and participants on the results, and the motivational importance of monitoring and assessing performance.

Conclusions

The results suggest that pedometer based walking interventions may be considered cost-effective and suitable for implementation within the wider community. However, several research gaps remain, including the importance and impact of the researcher/participant relationship, the impact of assessment on motivation and effectiveness, and the longer term impact on physical and mental health, resource utilisation and quality of life.

Trial registration

Current Control Trials Ltd ISRCTN88907382