title: Activity monitor intervention to promote physical activity of physicians-in-training: randomized controlled trial.
abstract: BACKGROUND
  Physicians are expected to serve as role models for healthy lifestyles, but long work hours reduce time for healthy behaviors. A hospital-based physical activity intervention could improve physician health and increase counseling about exercise.
  
  
  METHODS
  We conducted a two-phase intervention among 104 medical residents at a large hospital in Boston, Massachusetts. Phase 1 was a 6-week randomized controlled trial comparing daily steps of residents assigned to an activity monitor displaying feedback about steps and energy consumed (intervention) or to a blinded monitor (control). Phase 2 immediately followed and was a 6-week non-randomized team steps competition in which all participants wore monitors with feedback. Phase 1 outcomes were: 1) median steps/day and 2) proportion of days activity monitor worn. The Phase 2 outcome was mean steps/day on days monitor worn (≥500 steps/day). Physiologic measurements were collected at baseline and study end. Median steps/day were compared using Wilcoxon rank-sum tests. Mean steps were compared using repeated measures regression analyses.
  
  
  RESULTS
  In Phase 1, intervention and control groups had similar activity (6369 vs. 6063 steps/day, p = 0.16) and compliance with wearing the monitor (77% vs. 77% of days, p = 0.73). In Phase 2 (team competition), residents recorded more steps/day than during Phase 1 (CONTROL: 7,971 vs. 7,567, p = 0.002;
  
  
  METHODS
  7,832 vs. 7,739, p = 0.13). Mean compliance with wearing the activity monitor decreased for both groups during Phase 2 compared to Phase 1 (60% vs. 77%, p<0.001). Mean systolic blood pressure decreased (p = 0.004) and HDL cholesterol increased (p<0.001) among all participants at end of study compared to baseline.
  
  
  CONCLUSIONS
  Although the activity monitor intervention did not have a major impact on activity or health, the high participation rates of busy residents and modest changes in steps, blood pressure, and HDL suggest that more intensive hospital-based wellness programs have potential for promoting healthier lifestyles among physicians.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT01287208.
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
authors.forename: Anne N
authors.initials: AN
authors.lastname: Thorndike
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
authors.forename: Sarah
authors.initials: S
authors.lastname: Mills
authors.affiliation: Food and Nutrition Services, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
authors.forename: Lillian
authors.initials: L
authors.lastname: Sonnenberg
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
authors.forename: Deepak
authors.initials: D
authors.lastname: Palakshappa
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
authors.forename: Tian
authors.initials: T
authors.lastname: Gao
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
authors.forename: Cindy T
authors.initials: CT
authors.lastname: Pau
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
authors.forename: Susan
authors.initials: S
authors.lastname: Regan
mesh_terms: D000328:Adult; D001794:Blood Pressure; D001823:Body Composition; D002784:Cholesterol / Q000097:blood; D003163:Competitive Behavior; D003376:Counseling; D056228:Feedback, Sensory; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008991:Monitoring, Physiologic; D009043:Motor Activity; D010820:Physicians / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D002784:Cholesterol