The 10,000 Steps Rockhampton project promoted physical activity and 'step counting' in a multi-strategy community-based intervention. This paper is one of the first to describe the factors related to pedometer use in the general population, as well as to examine the effect of a multi-strategy community-based intervention on pedometer use. While pedometer use was modest (approximately one fifth of respondents to the population-based survey in Rockhampton), it was significantly more than in the comparison community of Mackay (5.6%). From a public health perspective this difference is relevant as it equates to approximately 7,200 adult community residents (from the intervention community of approximately 60,000 residents) using a pedometer.
Our evaluation of factors associated with pedometer use was consistent with results from the overall trial [14, 21], namely that women were the early adopters in terms of pedometer use and with regard to increases in physical activity. Pedometer use was also more likely among the employed and educated, suggesting that there is still considerable work to be done to improve pedometer use among those most in need (i.e., lower SES). However, it was encouraging that in Rockhampton, obese people were more likely to use pedometers. This finding is consistent with the results of the general practitioner strategy implemented as part of the 10,000 steps program, where respondents who were overweight or obese were more likely to report receiving physical activity advice from their GP . In contrast, in the comparison community, physical activity (being sufficiently active) was the only factor associated with pedometer use, suggesting that without intervention, pedometer use is likely to be more prevalent among those who are already active.
There are limited studies against which to compare our findings; there is no published report describing the natural history of pedometer use in the general population, and only one study has evaluated pedometer use in the context of a community-based intervention trial. In a descriptive study using pedometers to determine the average step counts of a general population sample, Tudor- Locke and colleagues found that two-thirds of those who agreed to participate were overweight or obese; they were also more likely to be white, to have a higher education, and to have a higher household income .
Similar findings were reported by Craig et al. from the Canada on the Move initiative, a physical activity (walking) awareness and promotion campaign involving mass marketing messages and distribution of pedometers in cereal boxes . This study reported that pedometer use was more likely among women and older people (44–64 years), as well as being associated with campaign awareness.
In our study, all the program exposure variables, with the exception of physical activity advice from the GP, were associated with an increased likelihood of pedometer use. While this suggests that the community-based physical activity intervention may have had an impact on pedometer use, the cross-sectional nature and resultant inability to infer causality should be noted. An alternative explanation is that those who had a pedometer may have been more likely to notice cues such as street signs and to engage with pedometer-related program strategies, such as visiting the website for more information or to log their steps.
Although they did not involve whole-of-community interventions, two other recent trials have evaluated the use of pedometers in specific community settings: workplaces and churches [7, 8]. The successful implementation of pedometer-based intervention protocols in both these trials provides further support for the efficacy of pedometers for use in reaching large numbers of people for physical activity promotion.
The strengths of this study include the use of pedometers as part of a whole-of-community approach to physical activity promotion, as well as use of a population-based survey to evaluate pedometer use and related socio-demographic and health correlates. The study results help us to better understand pedometer use in various subgroups, and highlight the need to target specific population subgroups not reached by the initial 10,000 Steps intervention. The limitations include the low survey response rate and the cross-sectional nature of the data. The fact that the pedometer use questions were not asked in the baseline survey is also a limitation, as we are unable to say whether those who reported using a pedometer were 'new' pedometer users. The much higher rate of use in Rockhampton does however strongly suggest that the intervention was successful.