Author + information
- Received February 19, 2016
- Revision received March 4, 2016
- Accepted March 9, 2016
- Published online May 31, 2016.
- Anand N. Ganesan, MBBS, PhDa,b,∗ (, )
- Jennie Louise, PhDc,
- Matthew Horsfall, RNd,
- Shane A. Bilsborough, MSce,
- Jeroen Hendriks, RN, PhDc,d,
- Andrew D. McGavigan, MDa,b,
- Joseph B. Selvanayagam, MBBS, D.Phila,b,d and
- Derek P. Chew, MBBS, MPHa,b,d
- aSchool of Medicine, Flinders University of South Australia, Adelaide, Australia
- bDepartment of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia
- cCentre for Heart Rhythm Disorders, University of Adelaide, Adelaide, Australia
- dHealth Systems Research, South Australian Health and Medical Research Institute, Adelaide, Australia
- eStepathlon Private Limited, Mumbai, India
- ↵∗Reprint requests and correspondence:
Dr. Anand N. Ganesan, Flinders University of South Australia, Department of Cardiovascular Medicine, Flinders Medical Centre, 1 Flinders Drive, Bedford Park 5042, South Australia.
Background Although proof-of-concept for mobile health (mHealth) life-style programs targeting physical inactivity and overweight/obesity has been established in randomized trials, the feasibility and effect of a globally distributed, large-scale, mass-participation mHealth implementation has not been investigated.
Objectives The purpose of this study was to determine the effect of Stepathlon, an international, low-cost, mass-participation mHealth intervention, on physical activity, sitting, and weight.
Methods We prospectively collected cohort data from participants completing Stepathlon, an annual 100-day global event in 2012, 2013, and 2014. Participants were organized in worksite-based teams, issued pedometers, and encouraged to increase daily steps and physical activity as part of the team-based race. The program was conducted via an interactive multiplatform application available on mobile devices and the Internet. Analysis was performed according to a pre-specified plan.
Results A total of 69,219 subjects participated (481 employers, 1,481 cities, 64 countries, all populated continents, age 36 ± 9 years, 23.9% female, 8.0% high-income countries, and 92.0% lower-middle income countries). After Stepathlon completion, participants recorded improved step count (+3,519 steps/day; 95% confidence interval [CI]: 3,484 to 3,553 steps/day; p < 0.0001), exercise days (+0.89 days; 95% CI: 0.87 to 0.92 days; p < 0.0001), sitting duration (−0.74 h; 95% CI: −0.78 to −0.71 h; p < 0.0001) and weight (−1.45 kg; 95% CI: −1.53 to −1.38 kg; p < 0.0001). Improvements occurred in women and men, in all geographic regions, and in both high and lower-middle income countries, and the results were reproduced in 2012, 2013, and 2014 cohorts. Predictors of weight loss included step increase, sitting duration decrease, and increase in exercise days (all p < 0.0001).
Conclusions Distributed mHealth implementation of a low-cost life-style intervention is associated with short-term, reproducible, large-scale improvements in physical activity, sitting, and weight. (Effect of the Stepathlon Pedometer Program on Physical Activity, Weight and Well-Being; ACTRN12615001310550)
Dr. Ganesan is supported by the National Health and Medical Research Council of Australia, Australian Early Career Health Practitioner Fellowship; and has received minor speaker fees from Biotronik. Mr. Bilsborough is an employee of Stepathlon Private Limited. Dr. Hendriks is supported by the National Heart Foundation of Australia and holds the Derek Frewin Lectureship from the University of Adelaide. Dr. McGavigan has served on the advisory board of Medtronic, St. Jude Medical, and Boston Scientific; has received lecture and/or consulting fees or honoraria from Biotronik, Medtronic, St. Jude Medical, Boston Scientific, Bayer, and Pfizer; and has received grant support from Medtronic and Biotronik. Dr. Selvanayagam has received lecture and/or consulting fees from Medtronic, St. Jude Medical, Biotronik, Bayer, and Boehringer Ingelheim; and has received research funding from Biotronik and St. Jude Medical. Dr. Chew has received grant support from Roche Diagnostics; and has received lecture fees from AstraZeneca. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 19, 2016.
- Revision received March 4, 2016.
- Accepted March 9, 2016.
- American College of Cardiology Foundation