What is STEP?

The Step Test Exercise Prescription (STEP) is a tool to help family physicians counsel and prescribe a personalized exercise program for their patients. Developed by family medicine researchers to meet the need for a valid instrument while addressing the barriers of time, cost and generalizability.

What does it do for you?

STEP enables family physicians to tailor physical activity advice by determining the stage of readiness patients have toward becoming more active. Based on this "staging", physicians are then given the tools to conduct an exercise assessment in their office, prescribe specific activity and monitor their change in fitness.

How does it work? STEP consists of 3 steps:

	Staging assessment - five questions are used to determine patient's readiness to start a regular activity program.
	STEP exercise assessment - using two small steps in the corner of an examination room, patients go up and down these two steps 20 times. Heart rate and time are recorded in a programmed device. Device determines fitness level and prescribes a "training" heart rate to guide physical activity intensity during patient's program.
	Counseling patients - is applied based on patient's stage, fitness and training heart rate. Supportive devices, including pedometers, are used to enhance fitness, adherence and enjoyment of active living programs.
	Follow up - is scheduled to monitor progress and modify the program based on changes in stage, fitness, and personal goals.

The program is delivered as part of an 18 hour MAINPRO-C Continuing Medical Education program of the College of Family Physicians of Canada (CFPC). STEP is endorsed by CFPC's Physical Activity and Health Strategy. It is distributed and provided by the research team at the Canadian Centre for Activity and Aging under the direction of Dr Robert J Petrella.

For doctors:

	A clinical syllabus to provide background information regarding physical activity and health, behavior change, as well as development of the STEP program in family practice.
	A workbook to engage the family physician in staging patients, and how to perform the STEP exercise assessment and training heart rate prescription.
	A two-step exercise device, pre-programmed training heart rate device, stop watch, prescription pads and fridge magnets.

For patients:

	Handouts for patients to allow them to develop strategies to increase activity opportunities in their community, activity log book.
	Pedometers (2) for those who reach appropriate stage. Quality assurance: STEP has been validated in various groups of patients and in a large clinical trial.

STEP is provided by a trained staff from the Canadian Centre for Activity and Aging and MAINPRO-C is linked to completion of the program under the direction of Dr Petrella. To learn more about STEP, contact the Canadian Centre for Activity and Aging, London, Canada, (voice) 519-661-1637; (fax) 519-661-1635 or petrella@uwo.ca.