Safe Steps: A Text Message Intervention to Increase Physical Activity After Emergency Department Discharge in Older Adults

Background : Older adults face increased risk of functional impairments after Emergency Department (ED) discharge, yet no evidence-based physical activity interventions exist for this population. Objective : To evaluate the feasibility, safety, and effectiveness of Safe Steps, a text message intervention designed to increase daily step counts among older adults discharged from the ED. Methods : In this single-center pilot study, we recruited ED patients aged ≥60 years reporting low physical activity (<7,500 steps/day OR <75 minutes/day walking). Participants received a pedometer and daily text messages to report steps and set weekly goals over 4 weeks. Feasibility was assessed via step count reporting rates, safety through fall monitoring, and effectiveness by changes in step counts. Results : Forty-three participants enrolled; 40 completed the study. Step reporting rates were 87.2%. Three participants reported falls, none attributed to activity. Low-active participants (<5,000 steps) increased steps by 23.3%. Participants rated intervention motivation 7.4/10. Conclusion : Safe Steps appears feasible, safe, and effective for promoting activity post-ED discharge, warranting further study.