Physical Activity Daily - An Internet-Based Walking Program for Patients With Peripheral Arterial Disease

With the aging of the American population, the numbers of adults with peripheral arterial
disease (PAD) will increase significantly over the next several decades. Patients with PAD
are at increased risk for morbidity and mortality including both cardiovascular and all-cause
mortality. While regular physical activity reduces risk for vascular events and is
recommended for treatment of PAD patients, few patients meet recommended goals. Exercise
programs which increase long-term adherence to walking can be an important contribution to
PAD treatment. Our Internet-based intervention, with an online community builds on a walking
enhancement program developed by members of our team and is shown to improve adherence among
patients with vascular disease such as coronary artery disease (CAD). Using a randomized,
controlled trial study design, we propose to test an automated Internet-based walking program
with a social media component, to improve long-term adherence to walking while increasing
walking distance, and health-related quality of life, among patients with PAD. Participants
will be randomized to 1 of four study groups: 1) weekly telephone counseling, 2) an
Internet-based walking program, 3) a combination of telephone counseling and Internet-based
walking program, or 4) a usual care group. The Internet-based walking program with a social
media component has been shown to increase both adherence to walking and overall walking
duration in populations with chronic complex conditions such as CAD and diabetes. There is a
strong need to develop interventions, easily generalizable to a real-world population, to
improve the reach of lifestyle interventions which result in improved physical function and
adherence to regular exercise among complex medical patients. Patients such as those with PAD
(a CAD risk equivalent) stand to benefit the most from such programs.