Utilizing such concepts as the World Wide Web, Stepping up to Health, a randomized control trial performed by Caroline Richardson, MD of University of Michigan, seeks to uncover whether online peer support can reduce attrition in an Internet-based pedometer walking program. The essential components of the program involve understanding how to motivate sedentary and obese people to walk and keep a physically active life. The study investigates the notion of online peer support, monitoring, and competition to encourage longevity of physical activity. Stepping Up to Health provides an internet walking program which is synced with a pedometer and participants receive graphical feedback on whether they are meeting their walking goals.

To determine whether online peer support will increase adherence to an Internet-based pedometer walking program.

Stepping up to Health shows that online communities can help reduce attrition within online health behavior change interventions.

The Stepping Up to Health promising practice was successful in achieving continued physical activity and decreased participant attrition. The randomized control trial included 324 participants positive in one or more of the following categories: overweight (BMI≥25), type II diabetes, and coronary artery disease. The participants were split into two randomly assigned groups, those with access to an online group where individuals could post and read messages and those with access solely to the data they had entered along with visual graphs of their progress. The benefits of person-to-person interaction were clearly shown.

There were many findings that illustrated how effective this intervention is at impacting people's well-being and activity. Both study groups increased their daily steps over the 16-week interval of pedometer use, while participants in the interactive community were 13% more likely to be "completers" by entering 20 days of walking information during the final month of the four month study (79% of those with the community compared to 66% of those without, p=0.02). Community participants were also more likely to remain active in the program longer than those without the posting/ reading capabilities (hazard ratio=0.47, 95% CI=0.25-0.90, p=.02). A third promising result was that those without social support were more likely to make and read posts on the online community than those with highly developed support systems (p<0.01). This shows that the practice successfully decreased participant attrition for those most at risk.