Can a motivational intervention overcome an unsupportive environment for walking: Findings from the Step-by-Step Study

Merom, Dafna, Bauman, Adrian, Phongsavan, Philayrath, Cerin, Ester, Kassis, Mazen, Brown, Wendy, Smith, Ben J. and Rissel, Chris (2009) Can a motivational intervention overcome an unsupportive environment for walking: Findings from the Step-by-Step Study. Annals of Behavioral Medicine, 38 2: 137-146. doi:10.1007/s12160-009-9138-z

Author Merom, Dafna
Bauman, Adrian
Phongsavan, Philayrath
Cerin, Ester
Kassis, Mazen
Brown, Wendy
Smith, Ben J.
Rissel, Chris
Title Can a motivational intervention overcome an unsupportive environment for walking: Findings from the Step-by-Step Study
Journal name Annals of Behavioral Medicine   Check publisher's open access policy
ISSN 0883-6612
Publication date 2009-10-06
Sub-type Article (original research)
DOI 10.1007/s12160-009-9138-z
Volume 38
Issue 2
Start page 137
End page 146
Total pages 10
Editor C.R. France
Place of publication New York, NY
Publisher Springer New York LLC
Collection year 2010
Language eng
Subject 111712 Health Promotion
920205 Health Education and Promotion
1106 Human Movement and Sports Science
Abstract Background Interventions to promote walking have rarely examined how their effects varied by the attributes of the physical environment. Purpose The purpose of this study is to examine whether perceptions of environmental walkability predicted change in walking behavior following an individual-based intervention to promote walking and whether the intervention buffered the effects of unsupportive environment for walking. Methods Inactive adults (aged 30–65 years, 85% women) who completed a 3-month randomized control trial comparing the effect of a single mail-out of a theoretically based self-help walking program (WP, n = 102); the same program plus a pedometer (WPP, n  = 105); and a “no-treatment” control group (C, n = 107). Measures included change in self-reported walking time for all purposes and in the proportion of people reporting regular walking (i.e., ≥150 min/week and ≥5 sessions/wk). Perceptions of environmental esthetics, safety from crime, proximity to destinations, access to walking facilities, traffic, streetlights, connectivity, and hilliness were assessed at baseline and dichotomized into “low” or “high” by the median score. Covariates were social support, self-efficacy, intention to change behavior, and sociodemographic characteristics. Results Adjusting for baseline walking, significant covariates, and study groups, walking time at follow-up was lower if streetlights or esthetics were perceived to be “low” (−24% and −22%, respectively) compared with “high” (p < 0.05). In “low” esthetic conditions, those in the WPP were significantly more likely than controls to increase total walking time (Exp (b) = 2.53, p < 0.01) and to undertake regular walking (OR = 5.85, 95% CI 2.60–12.2), whereas in esthetically pleasing environments, the between-group differences were nonsignificant. Conclusions Walkability attributes can influence individual-based walking programs. Some environmental barriers for walking can be overcome by motivational aids.
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Human Movement and Nutrition Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 8 times in Thomson Reuters Web of Science Article | Citations
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Created: Mon, 23 Nov 2009, 21:43:49 EST by Deborah Noon on behalf of School of Human Movement and Nutrition Sciences