{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:54:48Z","timestamp":1772672088085,"version":"3.50.1"},"reference-count":9,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:sec><jats:title>Importance<\/jats:title><jats:p>It is unclear how to effectively promote walking in people with peripheral artery disease (PAD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To test whether brief counseling delivered by allied health professionals increases step count in participants with PAD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>In this randomized clinical trial, participants with symptomatic PAD were recruited from sites in Australia and randomly allocated 1:1 to the counseling intervention or an attention control. Data were collected from January 2015 to July 2021, and data were analyzed from March to November 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Two 1-hour face-to-face and two 15-minute telephone counseling sessions designed to increase walking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was the between-group difference in change in daily step count estimated by accelerometer recordings over 7 days at baseline and 4 months, using imputation for missing values. Other outcomes at 4, 12, and 24 months included step count, 6-minute walk distance, and disease-specific and generic measures of health-related quality of life. Risk of major adverse limb events was assessed over 24 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 200 included participants, 144 (72.0%) were male, and the mean (SD) age was 69.2 (9.3) years. The planned sample of 200 participants was allocated to the counseling intervention group (n\u2009=\u2009102) or attention control group (n\u2009=\u200998). Overall, 198 (99.0%), 175 (87.5%), 160 (80.0%) and 143 (71.5%) had step count assessed at entry and 4, 12, and 24 months, respectively. There was no significant between-group difference in the primary outcome of change in daily step count over 4 months (mean steps, 415; 95% CI, \u221262 to 893; <jats:italic>P<\/jats:italic>\u2009=\u2009.07). Participants in the counseling group had significantly greater improvement in the secondary outcome of disease-specific Intermittent Claudication Questionnaire score at 4 months (3.2 points; 95% CI, 0.1-6.4; <jats:italic>P<\/jats:italic>\u2009=\u2009.04) and 12 months (4.3 points; 95% CI, 0.5-8.1; <jats:italic>P<\/jats:italic>\u2009=\u2009.03) but not at 24 months (1.2 points; 95% CI, \u22123.1 to 5.6; <jats:italic>P<\/jats:italic>\u2009=\u2009.57). Findings were similar for mean PAD Quality of Life Questionnaire component assessing symptoms and limitations in physical functioning (4 months: 1.5 points; 95% CI, 0.3-2.8; <jats:italic>P<\/jats:italic>\u2009=\u2009.02; 12 months: 1.8 points; 95% CI, 0.3-3.3; <jats:italic>P<\/jats:italic>\u2009=\u2009.02; 24 months: 1.3 points; 95% CI. \u22120.5 to 3.1; <jats:italic>P<\/jats:italic>\u2009=\u2009.16). There was no significant effect of the intervention on change in mean 6-minute walking distance (4 months: 9.3 m; 95% CI, \u22123.7 to 22.3; <jats:italic>P<\/jats:italic>\u2009=\u2009.16; 12 months: 13.8 m; 95% CI, \u22124.2 to 31.7; <jats:italic>P<\/jats:italic>\u2009=\u2009.13; 24 months: 1.2 m; 95% CI, \u221220.0 to 22.5; <jats:italic>P<\/jats:italic>\u2009=\u2009.91). The counseling intervention did not affect the rate of major adverse limb events over 24 months (12 [11.8%] in the intervention group vs 14 [14.3%] in the control group; <jats:italic>P<\/jats:italic>\u2009=\u2009.68).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Relevance<\/jats:title><jats:p>This randomized clinical trial found no significant effect of brief counseling on step count in people with PAD. Alternate interventions are needed to enable walking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>Australian New Zealand Clinical Trials Registry Identifier: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.anzctr.org.au\/Trial\/Registration\/TrialReview.aspx?id=366284&amp;amp;amp;isReview=true\">ACTRN12614000592640<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamacardio.2022.5437","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T16:02:35Z","timestamp":1675872155000},"page":"394","source":"Crossref","is-referenced-by-count":14,"title":["Effect of Brief Counseling by Allied Health Professionals on Step Count of People With Peripheral Artery Disease"],"prefix":"10.1001","volume":"8","author":[{"given":"Jonathan","family":"Golledge","sequence":"first","affiliation":[{"name":"Queensland Research Centre for Peripheral Vascular Disease, 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