Abstract
Background
This pilot study aimed to test whether increase in daily steps and day-to-day consistency in daily steps during the first several weeks of a physical activity intervention predicted outcomes.
Methods
This was a secondary analysis from two concurrent studies testing a positive psychology-motivational interviewing intervention to increase physical activity and positive affect in individuals with type 2 diabetes. Steps were measured with accelerometers at study assessments (baseline, end-of-treatment, and 8-week follow-up) and were measured daily throughout the intervention by participants using provided pedometers. We calculated change in steps from intervention week 1 to week 3, along with variability in daily steps over the first 3 weeks, using the best fitting regression line modeling their change. Multiple regression analyses tested whether these predictors were associated with change in physical activity at the end of treatment and at 8-week follow-up. Additionally, we explored the utility of specific cutoffs (e.g., 500 steps) for early step change using a minimum p-value approach.
Results
In 52 participants, larger step increases by week 3 predicted activity increase at end-of-treatment and follow-up. Variability in early steps was not associated with outcomes. Early increase cutoffs of 500 and 2000 steps may have practical relevance.
Conclusion
Early response to a physical activity intervention appears to be a useful predictor of outcome and could be used to identify those unlikely to succeed in a given intervention early in treatment.
Trial Registration
ClinicalTrials.gov identifiers NCT03150199 and NCT03001999
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Funding
Funding for the BEHOLD studies comes from the National Institute of Diabetes and Digestive and Kidney Diseases (R21DK109313, PI: Huffman) and the American Diabetes Association (grant 1-17-ICTS-099, PI: Huffman). Time spent on these analyses was funded by the National Heart Lung and Blood Institute (K23HL123607, PI: Celano; R01HL113272, PI: Huffman; and K23HL148017, PI: Feig).
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Feig, E.H., Harnedy, L.E., Celano, C.M. et al. Increase in Daily Steps During the Early Phase of a Physical Activity Intervention for Type 2 Diabetes as a Predictor of Intervention Outcome. Int.J. Behav. Med. 28, 834–839 (2021). https://doi.org/10.1007/s12529-021-09966-0
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DOI: https://doi.org/10.1007/s12529-021-09966-0