Can lay-led walking programmes increase physical activity in middle aged adults? A randomised controlled trial

Study objective: To compare health walks, a community based lay-led walking scheme versus advice only on physical activity and cardiovascular health status in middle aged adults. Design: Randomised controlled trial with one year follow up. Physical activity was measured by questionnaire. Other measures included attitudes to exercise, body mass index, cholesterol, aerobic capacity, and blood pressure. Setting: Primary care and community. Participants: 260 men and women aged 40-70 years, taking less than 120 minutes of moderate intensity activity per week. Main results: Seventy three per cent of people completed the trial. Of these, the proportion increasing their activity above 120 minutes of moderate intensity activity per week was 22.6% in the advice only and 35.7% in the health walks group at 12 months (between group difference =13% (95% Cl 0.003% to 25.9%) p=0.05). Intention to treat analysis, using the lost known value for missing cases, demonstrated smaller differences between the groups (between group difference =6% (95% Cl -5% to 16.4%)) with the trend in favour of health walks. There were improvements in the total time spent and number of occasions of moderate intensity activity, and aerobic capacity, but no statistically significant differences between the groups. Other cardiovascular risk factors remained unchanged. Conclusions: There were no significant between group differences in self reported physical activity at 12 month follow up when the analysis was by intention to treat. In people who completed the trial, health walks was more effective than giving advice only in increasing moderate intensity activity above 120 minutes per week.