Promoting Lifestyle Physical Activity: Experiences with the First Step Program

The purpose of this article is to describe a pedometer-based physical activity intervention (and the research that has been conducted on this program) to provide insight into workable strategies focused on promoting lifestyle physical activity. The First Step Program (FSP) is facilitated theory-based behavior modification program, originally developed for individuals with Type 2 diabetes, which capitalizes on the unique properties of a pedometer to serve as a stimulus for walking and an instrument for individual goal-setting, self-monitoring, and feedback. Formative evaluation revealed that participants were highly enthusiastic about the program and pilot testing demonstrated an immediate and dramatic increase in walking behavior (by approximately 3,700 steps/day or 34 minutes of walking a day). A randomized and controlled evaluation produced similar results, as have head-to-head comparisons of participant outcomes produced by professional vs. peer delivery, and adaptations of the program to worksite and community-based delivery. The effectiveness of the FSP can be explained by a thoughtful consideration of pedometer characteristics, program features, and the people who participate. Sustained delivery is contingent on funding sources and administrative structures that support formalized implementation.