Table 1 Description of the StepUp program

Contact with therapist

Week 1– face to face visit to introduce StepUp program

Week 2 and week 4 – 5 minute phone call to negotiate weekly step count goals

Week 6 - face to face visit to debrief re the StepUp program, and counsel re future plans for physical activity

Pedometer

MP-100 pedometer (Yamasa Corp; Chiba, Japan)

Step count targets

Step count targets for each week are negotiated with the therapist during the fortnightly phone call. Where the average daily step counts is < 6000 in the preceding week, the progressive goal aims to increase daily step counts by 10% compared with the previous week. Where the average daily step counts is > 6000 in the preceding week, the progressive goal aims to increase daily step counts by 5% compared with the previous week. Note that the 6,000 step cut off was based upon our previous research with children with cerebral palsy [9, 11].

StepUp handbook educational info & weekly topic

Background info on using a pedometer, dealing with fatigue/pain/injuries, and how to contact the physiotherapist.

Week 1 – “why be physically active”

Week 2 – “how much is enough?”

Week 3 – “Screen time”

Week 4 – “Staying motivated”

Week 5 – “Myth busters”

Week 6 – “Step it up!”

StepUp challenges

The StepUp handbook contains a number of 'mini challenges’ which participants can complete, such as “Half Hour Hero” (for taking 2000 steps in 30 minutes), “Early Bird” (1000 steps before school), “Nature Lover” (5000 steps going for a nature walk), “Shopaholic” (2000 steps at a shopping centre) etc.

Tourist circuit

Steps are tallied at the end of each week, and young people can see how far they have walked (e.g. 55,000 steps = “Mad Marathon” (approx. 42 km); 450,000 steps = “Euro Tripper” (walking approx. 343 km, the distance from London to Paris).

Wall chart

Young people are encouraged to hang the wall chart in a prominent place (e.g. the fridge or their bedroom) and mark off, or use provided stickers, to chart when they have met their daily step goal, and when they have earned “badges” for the challenges and tourist circuit.

Rewards

Participants are encouraged to negotiate rewards with their parents for meeting their daily step count target. The parent booklet gives many ideas for rewards (including rewards which have no cost).

Parent booklet

Parents receive a booklet with information for supporting their child in the StepUp program including negotiating rewards, ideas for encouraging the child and the whole family to be active, and the physiotherapist’s contact details.