There is evidence to suggest that physically active individuals have a significantly lower risk of developing type 2 diabetes compared to those who have a sedentary lifestyle, and that physical activity confers a similar risk reduction for coronary heart disease. Epidemiologic research has also demonstrated protective effects of varying strength between physical activity and obesity, high blood pressure, osteoporosis, colon cancer, and improved mental health. However, it is estimated that only 35% of men and 24% of women are currently meeting national guidelines for physical activity e.g. undertaking a minimum of 30 minutes of at least moderate intensity activity at least five times a week. Physical inactivity has costs for both individuals and for society – a recent consultancy report by Deloitte showed that meeting governmental exercise targets could save the UK up to half a billion pounds due to a reduced burden on the NHS, reduced absenteeism and insurers facing fewer health-related claims (Health of the Nation report, Deloitte, 2006). Consequently there is a need for effective interventions at both the individual and societal level to increase physical activity. The majority of research in this area has focussed on brief interventions to increase exercise in the general population delivered by health practitioners, often with very short follow-up (a few weeks). Most studies have used self-reported measures of activity. It remains unclear whether short-term increases in physical activity and associated improvements in health status can be maintained, and which factors are linked to long-term maintenance of activity.

The ProActive trial was set up in 2001 and aimed to find out whether teaching the skills of behaviour change could help people increase their physical activity and reduce their risk of type 2 diabetes over one year. We recruited 365 people at high risk of diabetes (due to their family history of disease) through their GP surgery. The trial aimed to address many of the shortcomings of previous research by focussing on a high risk group, and including objective measurement of physical activity and longer-term follow-up. Participants were randomly assigned to three groups: a leaflet by post with brief motivational advice on the benefits of increased activity (comparison group), or a physical activity promotion programme, delivered either by telephone (distance group) or face-to-face in the family home over one year by trained facilitators.

88% of those invited for one-year measurements agreed to take part, which is a great response and the main reason for the trial’s success.  After one year we found that, on average, everyone taking part had increased their physical activity by the equivalent of an extra 20 minutes of brisk walking every day. This is a big achievement and beneficial for health – we discovered that people who increased their physical activity reduced their risk of developing diabetes and related conditions. We reported results in several publications as well as newsletters to participants. We also discovered that people felt better about themselves as a result of the original intervention. We therefore propose to follow up all ProActive participants after five years and measure changes in physical activity and related health outcomes.

We want to see if the increased physical activity levels achieved in the orignial study have been sustained over time, and how much the changes in activity have affected the risk factors for conditions such as diabetes and cardiovascular disease. We wish to identify reasons why some people can increase physical activity and maintain this increase, and see if the observed improvements in self-perceived health were maintained. We will also be able to explore which factors are linked to successful maintenance of physical activity and how participants incorporate ideas of risk and physical activity in their general notions of health and well-being. Results from the five year follow-up of the ProActive participants can inform the design, development and targeting of future physical activity programmes. With this in mind we are inviting all members of the original ProActive trial (excluding those who expressed a wish to be removed from the study, or who have since passed away) to take part in a follow-up health check at one of our measurement centres at either Addenbrooke’s Hospital, Cambridge, or the Princess of Wales Hospital, Ely.  Participants will have a full health and fitness assessment, including measurements such as height, weight, body fat percentage and waist measurements. A lung capacity test will also be completed along side a treadmill test.  Volunteers will also be asked to complete three self-report questionnaires, and wear a heart rate and activity monitor for 4 days after the visit.