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Walk as directed! Adolescents' adherence to pedometer intervention protocol.

BACKGROUND
Despite frequent use of pedometers in interventions targeting youth PA, there is no literature that addresses the prevalence and reasons for protocol nonadherence.


METHODS
Adherence behaviors of early adolescents (n = 43; Meanage = 12.3 ± 1.0) in an 8-week, faith-based intervention were monitored/recorded. Students provided reasons for various aspects of protocol breach, which were used to develop a post intervention questionnaire. Analyses included calculations of frequency/percentage as well as cross tabulations/chi square to detect gender/age differences.


RESULTS
Over the intervention, recording PA in logs decreased by 85% and was attributed to forgetfulness and lack of time. For pedometers, highest-frequency events included error codes (n = 501), incorrect wear (37%, ≥ 1 day), and shaking (58%-69%, ≥ 1 time). Top reasons for shaking were to make up for lost step opportunities and get further along the route. Of permissible stepping strategies, males used ambulatory activity on the playground and stair usage more, while 6th graders used speed stepping in place more than their respective counterparts.


CONCLUSIONS
Students admit to basal levels of nonadherence, which should be taken into consideration when designing/implementing interventions. Integrating intervention tasks into the regular curriculum and providing sufficient opportunities to perform them may alleviate some barriers to adherence. Future research should attempt to confirm results in other school types/levels as well as quantify these behaviors in free-living or unstructured settings.