Welcome to the PACE-UP Trial
PACE-UP was a Randomised Controlled Trial of a Pedometer Intervention to Increase Walking in Adults. It was organised and coordinated by St George's, University of London and was undertaken in selected general practices in South West London.
Purpose of the study?
Most adults are less physically active than they need to be to stay healthy. We wanted to find out if people aged 45-75 years can become more active if they were given a pedometer (a monitor that counts steps) with a physical activity diary and guidance on a 12-week programme to increase their walking. The programme was tailored to their individual baseline physical activity level. We were also interested in testing whether offering individual support from a practice nurse would increase any benefits.
When did the study start and finish?
Study recruitment started in October 2012 and our last participant joined the study in November 2013. Our 3 year follow-up finished in October 2016.
Which practices were involved?
We are grateful to the staff and patients at the following general practices for their participation in the study (number of patients recruited in brackets):
- Chatfield Medical Centre, Battersea (127)
- Cricket Green Medical Practice, Mitcham (164)
- Dr H M Freeman & Partners (Upper Tooting Surgery & Trevelyan Road Surgery) (117)
- Francis Grove Surgery, Wimbledon (218)
- Putneymead Group Medical Practice (153)
- Wrythe Green Surgery, Sutton (189)
- The Heathbridge Practice, Putney (65)
What did we do?
The Pedometer And Consultation Evaluation-UP (PACE-UP) trial recruited 1023 inactive 45- to 75-year-olds from seven South London practices, and randomised them to a usual physical activity (control) group or to one of two intervention groups. The postal group participants were sent a pedometer, diary and 12-week pedometer-based walking programme, advising them to gradually add in 3000 steps or a 30-minute walk on 5 or more days weekly. The nurse-support group received the same materials through practice nurse physical activity consultations. Physical activity and participant-reported 12-month outcomes were compared with the beginning of the trial, along with the costs of each trial group. A further 3-year follow-up was conducted and long-term value for money was estimated.
What resources did participants use?
As part of the trial participants had already worn a monitor for 7 days so their baseline targets were set.
What did we find?
Both intervention groups significantly increased their walking (step counts and time in moderate-intensity physical activity) compared with controls, with no difference between nurse and postal groups. Interventions were safe and acceptable to participants and nurses. There was no effect on body size, pain or depression, but the nurse-support group participants increased their confidence in their ability to exercise. The 3-year follow-up found persistent positive effects of both interventions on physical activity levels. The postal intervention provided more value for money than the nurse-support group or the control group in the short and long term. A summary of the findings can be found here.
What does it mean?
A primary care pedometer intervention, delivered by post or with nurse support, could provide an effective way to increase physical activity levels in adults and older adults, with the postal route offering the most value for money. If you would like to try out the 12-week walking programme please click here.
This study was reviewed and given a favourable opinion by the London Hampstead Research Ethics Committee.