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Can a Motivational Intervention Overcome an Unsupportive Environment for Walking—Findings from the Step-by-Step Study

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Interventions to promote walking have rarely examined how their effects varied by the attributes of the physical environment.

Purpose

The purpose of this study is to examine whether perceptions of environmental walkability predicted change in walking behavior following an individual-based intervention to promote walking and whether the intervention buffered the effects of unsupportive environment for walking.

Methods

Inactive adults (aged 30–65 years, 85% women) who completed a 3-month randomized control trial comparing the effect of a single mail-out of a theoretically based self-help walking program (WP, n = 102); the same program plus a pedometer (WPP, n = 105); and a “no-treatment” control group (C, n = 107). Measures included change in self-reported walking time for all purposes and in the proportion of people reporting regular walking (i.e., ≥150 min/week and ≥5 sessions/wk). Perceptions of environmental esthetics, safety from crime, proximity to destinations, access to walking facilities, traffic, streetlights, connectivity, and hilliness were assessed at baseline and dichotomized into “low” or “high” by the median score. Covariates were social support, self-efficacy, intention to change behavior, and sociodemographic characteristics.

Results

Adjusting for baseline walking, significant covariates, and study groups, walking time at follow-up was lower if streetlights or esthetics were perceived to be “low” (−24% and −22%, respectively) compared with “high” (p < 0.05). In “low” esthetic conditions, those in the WPP were significantly more likely than controls to increase total walking time (Exp (b) = 2.53, p < 0.01) and to undertake regular walking (OR = 5.85, 95% CI 2.60–12.2), whereas in esthetically pleasing environments, the between-group differences were nonsignificant.

Conclusions

Walkability attributes can influence individual-based walking programs. Some environmental barriers for walking can be overcome by motivational aids.

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Acknowledgements

This study was funded by the National Heart Foundations. We thank the participants, the Central Sydney Area Health Service Health Promotion Unit staff, and NSW-wide Area Health Services for supporting this important study. We also thank the New South Wales (NSW) Health Department and Centre for Epidemiology and Research for facilitating the recruitment of potential participants through the NSW Population Health Survey Program.

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Authors and Affiliations

  1. School of Public Health, University of Sydney, Sydney, Australia

    Dafna Merom Ph.D., Adrian Bauman Ph.D. & Philayrath Phongsavan Ph.D.

  2. Institute of Human Performance, The University of Hong Kong, Hong Kong, SAR, China

    Ester Cerin Ph.D.

  3. Center for Epidemiology and Research, New South Wales Department of Health, Sydney, New South Wales, Ausrtralia

    Mazen Kassis B.Sc.

  4. School of Human Movement Studies, University of Queensland, Brisbane, Australia

    Wendy Brown Ph.D.

  5. Department of health Sciences, Monash University, Melbourne, Australia

    Ben J. Smith Ph.D.

  6. Health Promotion Service, Sydney South West Area Health Service, Camperdown, Australia

    Chris Rissel Ph.D.

  7. Cluster for Physical Activity and Health, School of Public Health, University of Sydney, Level 2, Medical Foundation Building, K25, 94 Parramatta Rd, Sydney, NSW, 2050, Australia

    Dafna Merom Ph.D.

Authors
  1. Dafna Merom Ph.D.
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  2. Adrian Bauman Ph.D.
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  3. Philayrath Phongsavan Ph.D.
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  4. Ester Cerin Ph.D.
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  6. Wendy Brown Ph.D.
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  8. Chris Rissel Ph.D.
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Correspondence to Dafna Merom Ph.D..

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Merom, D., Bauman, A., Phongsavan, P. et al. Can a Motivational Intervention Overcome an Unsupportive Environment for Walking—Findings from the Step-by-Step Study. ann. behav. med. 38, 137–146 (2009). https://doi.org/10.1007/s12160-009-9138-z

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  • DOI: https://doi.org/10.1007/s12160-009-9138-z

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