title: Effectiveness of an Activity Tracker- and Internet-Based Adaptive Walking Program for Adults: A Randomized Controlled Trial.
abstract: BACKGROUND
  The benefits of physical activity are well documented, but scalable programs to promote activity are needed. Interventions that assign tailored and dynamically adjusting goals could effect significant increases in physical activity but have not yet been implemented at scale.
  
  
  OBJECTIVE
  Our aim was to examine the effectiveness of an open access, Internet-based walking program that assigns daily step goals tailored to each participant.
  
  
  METHODS
  A two-arm, pragmatic randomized controlled trial compared the intervention to no treatment. Participants were recruited from a workplace setting and randomized to a no-treatment control (n=133) or to treatment (n=132). Treatment participants received a free wireless activity tracker and enrolled in the walking program, Walkadoo. Assessments were fully automated: activity tracker recorded primary outcomes (steps) without intervention by the participant or investigators. The two arms were compared on change in steps per day from baseline to follow-up (after 6 weeks of treatment) using a two-tailed independent samples t test.
  
  
  RESULTS
  Participants (N=265) were 66.0% (175/265) female with an average age of 39.9 years. Over half of the participants (142/265, 53.6%) were sedentary (<5000 steps/day) and 44.9% (119/265) were low to somewhat active (5000-9999 steps/day). The intervention group significantly increased their steps by 970 steps/day over control (P<.001), with treatment effects observed in sedentary (P=.04) and low-to-somewhat active (P=.004) participants alike.
  
  
  CONCLUSIONS
  The program is effective in increasing daily steps. Participants benefited from the program regardless of their initial activity level. A tailored, adaptive approach using wireless activity trackers is realistically implementable and scalable.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT02229409, https://clinicaltrials.gov/ct2/show/NCT02229409 (Archived by WebCite at http://www.webcitation.org/6eiWCvBYe).
authors: MeYou Health LLC, Boston, MA, United States.
authors: Josée
authors: http://orcid.org/0000-0002-1302-869X
authors: J
authors: Poirier
authors: Wendy L
authors: http://orcid.org/0000-0001-9828-0706
authors: WL
authors: Bennett
authors: Gerald J
authors: http://orcid.org/0000-0003-0612-2626
authors: GJ
authors: Jerome
authors: Nina G
authors: http://orcid.org/0000-0003-4282-6647
authors: NG
authors: Shah
authors: Mariana
authors: http://orcid.org/0000-0002-3178-6734
authors: M
authors: Lazo
authors: Hsin-Chieh
authors: http://orcid.org/0000-0002-5738-0652
authors: HC
authors: Yeh
authors: Jeanne M
authors: http://orcid.org/0000-0003-1194-0092
authors: JM
authors: Clark
authors: Nathan K
authors: http://orcid.org/0000-0003-4210-226X
authors: NK
authors: Cobb
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D017216:Telemedicine / Q000706:statistics & numerical data*; D016138:Walking / Q000193:education*
keywords: RCT; adaptive; effectiveness; intervention; physical activity; walking