Sophia Step Study- support for physical activity


Sophia Step Study- support for physical activity in prediabetes and type 2 diabetes


Physical activity is a cornerstone in type 2 diabetes care and health care services should offer support for physical activity to reduce disease progression and complications. Yet, a majority of people with prediabetes and type 2 diabetes are inactive today. Interventions should be tailored, enjoyable and useful for the individuals in order to be sustainable and support for behaviour change is time consuming. With the increasing number of individuals with prediabetes and type 2 diabetes new solutions are necessary. Step counters and digital technologies are promising tools for providing support for physical activity. Yet, little is known about long-term effectiveness and about combining digital technology with follow-up and support from health care professionals.


Sophia Step Study aims to evaluate the effects of step counters and a digital platform as tools for self-management of physical activity.


Sophia Step Study is a randomised controlled study. Patients with prediabetes or type 2 diabetes have been invited to participate and were randomised to one of three groups after a first health check-up. Participants in one of the three groups were offered step counters (pedometers) and digital support supplemented with group sessions and individual counselling by their diabetes specialist nurse. Participants in a second group were offered pedometers and digital support, and participants in the third group constituted a control group with standard care. Intervention duration was two years and data on clinical risk markers for type 2 diabetes and cardiovascular disease, objectively measured physical activity and psychosocial parameters have been collected repeatedly. Participants were recruited at the Primary Care Center and Insurance Clinic at Sophiahemmet in Stockholm and at Smedby Health Care Center located in southern Sweden. The study started in 2013 and was data collection was finalized in January 2020.


Digital technology has potential to assure continuity and quality of the care process based on the needs and preferences of the individual. Applying digital support is a mean to implement and strengthen a health promoting care and enables people to increase control over their own health. A person centered and personalised care, shared decision making, support and follow-up of self-management may lead to engaged and informed patients and enhanced disease management. Sophia Step Study evaluates if step counters combined with digital support is a feasible and effective method to use in the primary care context to increase regular physical activity and improve cardiometabolic risk factors. The study will also reveal if strengthened support with group sessions and individual consultation during two years gives superior effect.


King Gustaf V and Queen Drottning Victoria’s Order of Freemasons Research Foundation, The Sibling Svenssons’s Foundation for Medical Research, The Swedish Diabetes Foundation, Skandia, Sophiahemmet foundation and Vårdalsstiftelsen.


Project responsible: Jenny Rossen, Post doc, Department of Health promotion, Sophiahemmet University. Research group: Unn-Britt Johansson, Professor, Sophiahemmet University, Maria Hagströmer, Professor, Department of Neurobiologi, Care Sciences and Society, Karolinska Institutet, Patrick Bergman, associate professor, eHealth Institute, Linné University, Kristina Larsson, PhD student, Department of Health promotion, Sophiahemmet University and Yohannes Woldamanuel, PhD student, Department of Health promotion, Sophiahemmet University.