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Background  Physical inactivity is one of the leading causes of chronic disease in Canadian adults. With less than 50% of Canadian adults reaching the recommended amount of daily physical activity, there is an urgent need for effective programs targeting this risk factor. Health e Steps™ is a healthy lifestyle prescription program, developed from an extensive research base to address risk factors for chronic disease such as physical inactivity, sedentary behaviour and poor eating habits. Health e Steps™ participants are provided with in-person lifestyle coaching and access to  e Health technologies delivered in community-based primary care clinics and health care organizations.    Method/Design  To determine the effectiveness of Health e steps™, we will conduct a 6-month pragmatic randomized controlled trial with integrated process and economic evaluations of Health e Steps™ in 5 clinic settings in Southwestern Ontario. 110 participants will be individually randomized (1:1; stratified by site) to either the intervention (Health e Steps™ program) or comparator (Wait-list control). There are 3 phases of the Health e Steps™ program, lasting 6 months each. The  active phase  consists of bi-monthly in-person coaching with access to a full suite of  e Health technology supports. During the  maintenance phase I , the in-person coaching will be removed, but participants will still have access to the full suite of  e Health technology supports. In the final stage,  maintenance phase II , access to the full suite of  e Health technology supports is removed and participants only have access to publicly available resources and tools.    Discussion  This trial aims to determine the effectiveness of the program in increasing physical activity levels and improving other health behaviours and indicators, the acceptability of the Health e Steps™ program, and the direct cost for each person participating in the program as well as the costs associated with delivering the program at the different community sites. These results will inform future optimization and scaling up of the program into additional community-based primary care sites.    Trial registration    NCT02413385  (Clinicaltrials.gov). Date Registered: April 6, 2015.

bmc public health

HealtheSteps™ Study Protocol: a pragmatic randomized controlled trial promoting active living and healthy lifestyles in at-risk Canadian adults delivered in primary care and community-based clinics