Effects of a multilevel intervention on step counts in older adults at three months

Purpose: Older adults in retirement communities are among the least active population segment. In a randomized controlled trial, assess whether a multi level intervention including individual, interpersonal and environmental components increased step counts in older adults living in continuing care retirement communities.

Methods: Older adults (average age 83) were recruited from 11 retirement communities. The communities were randomized to an attention control condition or a multilevel walking intervention. Participants were encouraged to increase daily steps by 3000 over a three month period. Participants received a pedometer, logs, progress charts, individual counseling, group education and problem solving, and maps of community and neighborhood walks. Step counts were measured at baseline and 3 months by Actigraph accelerometer. Repeated measures analyses of variance were performed adjusting for age and gender. Average daily step counts were log transformed and standardized to 12 hours of wear.

Results: In 247 participants, there was a significant time x group interaction (F=7.7, p =.006). In the intervention group, daily step counts increased by 877 steps; from 8708.0 (SD 265.2) to 9585.4 (SD 341.4). In the attention control condition, daily step counts reduced by 163 steps; from 8225.6 (SD 242.0) to 8062.7 (SD 278.8).

Conclusions: A multilevel intervention succeeded in increasing step counts in an elderly and vulnerable population who would naturally be reducing their physical activity levels.