Promoting physical activity in a multi-ethnic population at high risk of diabetes: the 48-month PROPELS randomised controlled trial
Open accessAbstract
BACKGROUND: Physical activity is associated with a reduced risk of type 2 diabetes and cardiovascular disease but limited evidence exists for the sustained promotion of increased physical activity within diabetes prevention trials. The aim of the study was to investigate the long-term effectiveness of the Walking Away programme, an established group-based behavioural physical activity intervention with pedometer use, when delivered alone or with a supporting mHealth intervention. METHODS: Those at risk of diabetes (nondiabetic hyperglycaemia) were recruited from primary care, 2013-2015, and randomised to (1) Control (information leaflet); (2) Walking Away (WA), a structured group education session followed by annual group-based support; or (3) Walking Away Plus (WAP), comprising WA annual group-based support and an mHealth intervention delivering tailored text messages supported by telephone calls. Follow-up was conducted at 12 and 48 months. The primary outcome was accelerometer measured ambulatory activity (steps/day). Change in primary outcome was analysed using analysis of covariance with adjustment for baseline, randomisation and stratification variables. RESULTS: One thousand three hundred sixty-six individuals were randomised (median age = 61 years, ambulatory activity = 6638 steps/day, women = 49%, ethnic minorities = 28%). Accelerometer data were available for 1017 (74%) individuals at 12 months and 993 (73%) at 48 months. At 12 months, WAP increased their ambulatory activity by 547 (97.5% CI 211, 882) steps/day compared to control and were 1.61 (97.5% CI 1.05, 2.45) times more likely to achieve 150 min/week of moderate-to-vigorous physical activity. Differences were not maintained at 48 months. WA was no different to control at 12 or 48 months. Secondary anthropometric and health outcomes were largely unaltered in both intervention groups apart from small reductions in body weight in WA (~ 1 kg) at 12- and 48-month follow-up. CONCLUSIONS: Combining a pragmatic group-based intervention with text messaging and telephone support resulted in modest changes to physical activity at 12 months, but changes were not maintained at 48 months. TRIAL REGISTRATION: ISRCTN 83465245 (registered on 14 June 2012).
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Counseling interventions designed to promote walking through pedometers in the general population or in individuals with prediabetes or type 2 diabetes resulted in up to about 8 min/day increases in MVPA after 1 year and smaller (about 4 min/day), or even no, increments after longer follow-up, together with no change in SED-time.
“Counseling interventions designed to promote walking through the provision of pedometers in the general population (8) or in individuals with prediabetes (9) or type 2 diabetes (10,11) resulted in up to $8 min Á day À1 increases in MVPA after 1 year and smaller ($4 min Á day À1 ), or even no, increments after longer follow-up, together with no change in SED-time.”
In these walking intervention studies, the intervention failed to significantly improve CVD risk factors and other surrogate outcomes.
“However, in these studies, the intervention failed to significantly improve CVD risk factors and other surrogate outcomes (8)(9)(10)”
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- Authors
- Khunti, K., Griffin, S., Brennan, A., Dallosso, H., Davies, M. J., Eborall, H. C., Edwardson, C. L., Gray, L. J., Hardeman, W., Heathcote, L., Henson, J., Pollard, D., Sharp, S. J., Sutton, S., Troughton, J., & Yates, T.
- Affiliations
- University of Leicester (GB)
- University of Cambridge (GB)
- University of Sheffield (GB)
- University Hospitals of Leicester NHS Trust (GB)
- University of Edinburgh (GB)
- University of East Anglia (GB)
- Corresponding author
- Khunti, Kamlesh
- ORCID
- Venue
- BMC Medicine
- Published
- 2021-06-03
- Volume
- 19
- Issue
- 1
- Pages
- 130-130
- ISSN
- 1741-7015 (ISSN-L)
- PMC
- PMC8173914
- OpenAlex
- W3165548082
- Cited by
- 39
- References
- 34
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 13 · 2023: 5 · 2022: 7 · 2021: 2
- FWCI
- 4.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- UEA Digital Repository (University of East Anglia) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- Apollo (University of Cambridge) (submittedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Apollo
- Apollo (cc-by)
- Funders
- NIHR Health Technology Assessment Programme (HTA 09/162/02)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- physical activity promotion, type 2 diabetes prevention, pedometers, mobile health intervention, text messaging, telephone support, moderate-to-vigorous physical activity, step count, body weight, ethnic minorities, primary care, accelerometer-measured activity, maintenance of behaviour change
- MeSH terms
- Diabetes Mellitus, Type 2, Female, Humans, Middle Aged, Exercise, Walking, Actigraphy, Text Messaging
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