# Evaluation of a text message + pedometer intervention to increase steps after emergency department discharge: a pilot study

## TL;DR

A pilot study tested a text message and pedometer program to help older adults increase physical activity after leaving the emergency department.

## Contribution

The study introduces Safe Steps, a novel intervention combining text messages and pedometers to promote post-ED activity in older adults.

## Key findings

- Daily step reporting was high, with 95% of weeks having two or more readings.
- No falls were reported as a result of the intervention.
- Participants increased their step count by an average of 359 steps per week.

## Abstract

Older adults face increased risk of functional impairments after Emergency Department (ED) discharge, yet no evidence-based interventions exist for this population.

To evaluate the feasibility, safety, and effectiveness of Safe Steps, a text message + pedometer intervention designed to motivate individuals to meet step count goals.

We recruited ED patients aged ≥ 60 with low physical activity. Participants received a pedometer in the ED, daily text messages to report steps, and weekly prompts to set step goals over 4 weeks. We assessed step count reporting rates, falls, and change in steps over time.

Among analyzed participants (n = 40), daily step reporting was high (95% of weeks with 2 + readings). No participants had falls due to the intervention. Step count increased by a mean of 359 steps per week (95% confidence interval 182–536).

Safe Steps appears feasible, safe, and may be effective for promoting activity after ED discharge.

The online version contains supplementary material available at 10.1007/s40520-025-03030-7.