Implementation of a 12‐week pharmacist-lead walking program designed to
increase physical activity and improve overall health of participants
Amy M. Fanous, PharmD, Michael J. Rush, PharmD CDE BCACP, Karen L. Kier, PhD BCPS BCACP
Authors of this presentation have no known financial or personal relationships with commercial entities that may have a direct or indirect interest in the subject matter of this presentation
 Seventy million Americans, or approximately 22% of the
U.S. population, are considered to be inactive. This rate of
inactivity has increased by 8% over the last 3 years.1
Physical inactivity increases the risk of many adverse health
conditions, including coronary heart disease and type 2
2
diabetes mellitus, and also shortens life expectancy.
Increases in chronic conditions due to sedentary lifestyles
and poor fitness have led to numerous intervention strategies
to promote increased physical activity with the hope of
improving health substantially.
Evidence suggests that pedometers, combined with a goal
setting program, can be an effective short term motivational
tool to increase walking by between 2,000 and 2,500 steps
per day.3,4
ONU HealthWise is an interdisciplinary disease state
management and preventive medicine program. After the
two years of operation, the disease state management clinic
showed improved clinical outcomes and economic
5,6,7
savings. It was decided that a walking program could be
added to the preventive medicine aspect of HealthWise.
Participants reported for a baseline appointment and received a pedometer, a
calendar with walking goals, and maps with walking routes designed for campus
buildings.
Participants then met with a pharmacist and/or student for a point of care test
lipid panel, fasting glucose, and blood pressure. The participants were educated
on the goals for each test, the risks associated with having clinical lab values not
at goal, and counseled on ways to improve the lab values and overall health.
Each participant then met with an exercise physiologist who checked the
participant’s weight, BMI, waist to hip ratio, and body composition (a measure of
percent body fat).
Participants had the option of participating in the program either individually
or as part of a walking team.
Participants reported for weekly pedometer checks. Each week the walking
goal was met, the participant received a raffle ticket for a chance to win a prize.
Each week, the top three walkers and top three teams were posted on the
website (http://www.onu.edu/community/healthwise/walking_for_wellness).
Blood pressure and weight were reassessed at week 4 and week 9.
Prizes were given out at weeks 3, 6, 9, and 12 as incentives to encourage
continued participation.
After 12 weeks, participants will report for a final appointment
where all clinical parameters that were checked at baseline will be
reassessed by the multidisciplinary team of healthcare
professionals: lipid panel, fasting glucose, blood pressure, weight,
BMI, waist to hip ratio, and body composition.
The study was approved by ONU’s Institutional Review Board.
Screened at baseline: 144 patients
New conditions found by pharmacist: 240
Undiagnosed Conditions Found at Baseline
Condition
(n)
Quality measure
Diabetes Mellitus
1
Hgb A1c > 6.5%
Pre-Diabetes Mellitus
77
FBG > 100 mg/dL
Dyslipidemia
92
Per NCEP *
Elevated BP (>120/80)
70
Per JNC7
*Individualized LDL goals based on risk
To determine if a pharmacist-directed walking program will
motivate employees to increase their physical activity and
provide a means for participants to improve overall health.
Participants are eligible to be included in the study if they
are a present or retired faculty or staff member of the
university, or their spouse.
Participants will be excluded if they are unable to complete
the twelve week length of the program or if they have a new
diagnosis of a disease state that requires a change in or start
of medication that could modify the parameters tested.
Baseline
Week 7 8,000 steps per day
Week 2 5,500 steps per day
Week 8 8,500 steps per day
Week 3 6,000 steps per day
Week 9 9,000 steps per day
Week 4 6,500 steps per day
Week 10 9,500 steps per day
Week 5 7,000 steps per day
Week 11 10,000 steps per day
Week 6 7,500 steps per day
Week 12 10,000 steps per day
Week 9
Week 12*
No. of participants (%)
Elevated BP
94 (65.28%)
68(65.38%)
43 (71.67%)
Pending
Weight loss from
baseline
N/A
-2.92%
-6.60%
Pending
Low HDL
Elevated LDL
Week 1 5,000 steps per day
Week 4
Hyperglycemia
73
(50.69%)
13 (9.03%)
91 (63.19%)
Pending
Pending
Pending
80,000
70,000
60,000
50,000
40,000
1
2
3
4
5
6 7 8
Week
100
50
0
1
2
3
4
5
6 7
Week
*Final results from weeks 11 & 12 are pending and will be submitted for publication.
1.
2.
3.
4.
5.
6.
7.
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Participants Who Met Step Goal
Percentage
Lab Parameters
Weekly Steps
Average Steps Per Person
2012 Sports, Fitness and Leisure Activities Topline Participation Report. Rep. Jupiter: SGMA Research/Sports Marketing Surveys USA, 2012. Web. 9 Oct. 2012. http://assets.usta.com/assets/1/15/SGMA_Research_2012_Participation_Topline_Report.pdf.
Lee IM, Shiroma EJ, Lobelo F, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet.Web. 18 July 2012;6736(12)61031-9.
Bravata DM, Smith-Spangler C, Sundaram V, et al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA 2007;298(19):2296-2304.
Kang M, Marshall SJ, Barreira TV, Lee JO: Effect of pedometer-based physical activity interventions: a meta-analysis. Res Q Exerc Sport 2009;80(3):648-655.
Personal communication from Mike Rush, Director of ONU HealthWise, to Amy Fanous on October 15, 2012 (report available upon request to m-rush@onu.edu).
Rush MJ, Bright DR, Kier KL. ONU HealthWise: First-Year Clinical and Economical Outcomes for a University-Based, Pharmacist-Directed, Interdisciplinary Health and Wellness Clinic. Abstract. J Am Pharm Assoc. 2012;52:2.
Rush MJ, Kier KL, Murphy BL, Amero JL, Peters CR. ONU HealthWise: Clinical Results of a Pharmacist-Conducted Osteoporosis Screening as a Component of a University-Based Health and Wellness Clinic. Abstract. J Am Pharm Assoc. 2012;52:2.
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