Effectiveness of a walking programme to support adults with XXXX to increase physical activity: walk well cluster-randomised controlled trial.

@entity1 @entity717 @entity28
BACKGROUND: Programs to change health behaviours have been identified as one way to reduce health inequalities experienced by disadvantaged groups. The objective of this study was to examine the effectiveness of a behaviour change programme to increase walking and reduce sedentary behaviour of adults with @entity717 . METHODS: We used a cluster randomised controlled design and recruited @entity1 over 18  years old and not regularly involved in physical activity from @entity717 community-based organisations. Assessments were carried out blind to allocation. Clusters of @entity1 were randomly allocated to the Walk Well program or a 12-week waiting list control. Walk Well consisted of three face-to-face physical activity consultations incorporating behaviour change techniques, written resources for @entity1 and carers, and an individualised, structured walking programme. The primary outcome measured with accelerometers was change in mean step count per day between baseline and 12  weeks. Secondary outcomes included percentage time per day sedentary and in moderate-vigorous physical activity (MVPA), body mass index (BMI), and subjective well being. RESULTS: One hundred two @entity1 in 50 clusters were randomised. 82 (80.4  %) @entity1 completed the primary outcome. 66.7  % of @entity1 lived in the most deprived quintile on the Scottish Index of Multiple Deprivation. At baseline, @entity1 walked 4780 (standard deviation 2432) steps per day, spent 65.5  % (standard deviation 10.9) of time sedentary and 59  % percent had a body mass in the @entity28 range. After the walking programme, the difference between mean counts of the Walk Well and control group was 69.5 steps per day [95  % confidence interval (CI) -1054 to 1193.3]. There were no significant between group differences in percentage time sedentary 1.6  % (95  % CI -2.984 to 6.102), percentage time in MVPA 0.3  % (95  % CI -0.7 to 1.3), BMI -0.2  kg/m(2) (95  % CI -0.8 to 0.4) or subjective well-being 0.3 (95  % CI -0.9 to 1.5). CONCLUSIONS: This is the first published trial of a walking program for adults with @entity717 . Positively changing physical activity and sedentary behaviours may require more intensive programmes or upstream approaches to address the multiple social disadvantages experienced by adults with @entity717 . Since @entity1 spent the majority of their time sedentary, home-based programmes to reduce sitting time may be a viable health improvement approach. TRIAL REGISTRATION: Current Controlled Trials ISRCTN50494254.
