The development of an intervention to promote walking in primary care

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Obesity has more than doubled in the UK over the past decade, largely because people are less active in their daily lives, e.g. by driving more and watching more television. Current government recommendations are that people should engage in at least 30 minutes of ?moderate or vigorous? exercise, for at least five days each week, to gain health protective benefits. However, over 60% of men and 70% of women in England and Wales do not meet these requirements, with activity decreasing with age. Health problems due to physical inactivity, such as diabetes, are expected to increase dramatically in the future as a consequence, and may soon overtake smoking as the behaviour which causes most ill-health and premature death. This research aims to promote ?brisk? walking, i.e. walking that results in being slightly out of breath. Walking can be done by most people without any special equipment, at times that suit them. We have developed an intervention that can be delivered in about 10-15 minutes. It asks participants to set realistic goals for increasing their walking, boosts confidence by asking participants to recall instances when they have achieved these goals, and helps people put their good intentions into action, by making concrete plans. It helped 130 volunteers increase their walking, as measured by pedometers, from an average of 20 mins/day to 32 mins/day. These increases were maintained for at least six weeks.This proposal aims to adapt this intervention so that it can be delivered in primary care by practice nurses and health trainers, targeted at patients for whom increasing physical activity is a health priority. It will be developed to be acceptable to those delivering it, easy to deliver as intended and acceptable to patients attending primary care. There is a need to develop a study of how much this intervention would affect walking if it were adopted more widely, and for how long increases would last. The intervention, including materials and training, will be developed and refined to maximise the acceptability of the intervention. Methods of evaluating the efficacy of this intervention will be developed, to recruit and retain people into the study, with acceptable measures of beliefs about walking, actual walking, and healthcare costs. It will also investigate the reasons why some people increase their walking and some do not. This will lay the basis for a more definitive study of the effectiveness of the intervention.