The "10,000 Steps Ghent" whole community intervention was effective in increasing step counts: almost half the intervention participants increased their step counts on average by 896 steps/day or more at one-year follow-up. However, the proportion of intervention participants using a pedometer through loan or sale service during the intervention was modest (16%). The purpose of the present study was to investigate which individual characteristics and exposure variables were associated with pedometer use and step count increase.
Pedometer use in Ghent (16%) was remarkably similar to that in the Australian "10,000 Steps" intervention in Rockhampton (18%) . The predictors of pedometer use were also very similar in these two studies and in the "Canada on the Move" intervention. For example, in all three studies older people (over 49 in Ghent, over 45 in Rockhampton , and in the 44–64 year age group in Canada ) were more likely to have used a pedometer. Other previous pedometer-based studies have shown that PA is inversely associated with age [24–26], so the finding that pedometer use is more prevalent among older people is encouraging. Furthermore, in all three studies, individuals being exposed to program variables (having heard or seen a message about PA promotion and knowing about the "10,000 Steps" project in Ghent; having seen the street signage/walking trials and visited the website in Rockhampton ; and campaign awareness in Canada ) were more likely to report using a pedometer. The latter seems a logical finding, however explaining why older participants were more likely to use a pedometer is difficult, as participants who were aware of PA promotion messages or the "10,000 Steps Ghent" project, were no more likely to be older than 49 years than those who were unaware. It is possible that older people had more time or more interest in trying out a pedometer. Mostly, they care for their health, and like to have defined guidelines and goals concerning their health behavior. Using a pedometer gives them the opportunity to set and reach goals regarding their PA.
Although pedometer use was more likely among women, and employed and higher educated individuals in Rockhampton , and more likely among women, college and university graduates, and high-income earners in Canada , gender, education and employment status were not significantly associated with pedometer use in the present Ghent study.
Participants with a college or university degree were however more likely to record a step count increase in this project, suggesting that more efforts are needed to reach those with lower levels of education. A previous cross-sectional pedometer study conducted in the United States, also revealed that higher educated individuals had significantly more daily step counts than lower educated persons . Wyatt et al  on the other hand, found that steps did not differ significantly as a function of education level in Colorado. However, in the present study, there was a tendency for those with higher education to have a baseline step count below 10,000 steps/day. Furthermore, the present findings showed that less active individuals (i.e. those with a baseline step count level below 10,000 steps/day, and consequently those with a college or university degree) were more likely to increase their steps. This promising outcome suggests that the whole-community intervention, which was designed to reach sedentary people, was indeed effective for those most in need of (more) PA, and not for already active individuals.
As pedometer use was only one of the strategies promoted during this multi-component intervention, it was interesting to find that it was associated with the observed increase in step counts. Our analyses showed that the multi-strategy intervention was successful in promoting and stimulating pedometer use, which in turn resulted in positive step count changes. The intervention effect was however only partly mediated by pedometer use (2,8%), which is not surprising as only one in six people reported using a pedometer. The findings suggest that, although the pedometer was valuable in promoting increased step counts in a whole community, the other strategies (the media campaign, street signs, website, workplace projects, working with health professionals and targeting older people) could also be important. Post hoc mediation analyses showed that the intervention was significantly mediated by awareness through street signs (11.1% mediation) and workplace projects (7.3% mediation). This suggests that promotion, available for the whole community (i.e. street signs), or in smaller settings (i.e. workplaces) has an effect on step count change. The latter mediating effects were even greater than that of pedometer use, which was thought to be an important mediator of the intervention. Notwithstanding, this is the first time that the mediating effect of pedometer use on increasing activity has been demonstrated in a whole community intervention.
One limitation of this study is that the questions about pedometer use were not asked at baseline, so information on pre-intervention pedometer use was not available. However, a previous Belgian study  has shown that pedometer use was not common in East-Flanders at the time that this intervention was implemented. A second limitation is the lack of information on BMI or other health variables, and additional socio-demographic variables like marital status, income and job classification. The strengths of this study include the large sample size, the random sample of participants for the evaluation (i.e. they were not 'volunteers' in the intervention program), the age range (25–75 years), and the longitudinal step count data.