it is well documented that regular physical activity ( pa ) has many health benefits [ 1 , 2 ] and that there is a dose - response association between pa and all - cause mortality [ 3 , 4 ] . however , the pa of the majority of adults does not reach recommended levels , although there seem to be relatively stable or slightly increasing levels of leisure - time pa .
only 20% of norwegian adults meet the recommended daily requirement for 30  min of moderate - intensity activity . declining levels of work - related activity , transportation activity , and activity at home
the effectiveness of interventions that promote and increase pa has been studied , and there is strong evidence that public health efforts can successfully increase pa [ 8 , 9 ] .
the most cost - effective interventions , such as sign to prompt stair use , reached a high number of people using low - intensity ( and low - cost ) methods .
however , the benefit was limited since these interventions were insufficient on their own to significantly increase the proportion of individuals who satisfied pa recommendations .
the least cost - effective interventions were high - intensity  individually adapted behavior change  and  social support  programs .
these programs had the largest effect sizes ( largest increase in met hours per person per day ) but had a higher cost since they required more face to face counseling or interaction compared to more cost - effective interventions .
many of these individually adapted behavior change programs have much in common in terms of exercise progression , diet , and motivation .
if a program similar to those with a large effect size could be scaled up to reach a large number of people , it would be a cost - effective intervention for increasing pa .
an increasing interest in health , fitness , and exercise features in newspapers and magazines has made collaboration with media possible .
health and exercise researchers can design interventions that may help to increase pa and public health behavior , and newspapers can cover the stories of the intervention participants . if the intervention could motivate the newspapers ' readers to be more physically active , and these articles attract new readers , this is a win - win situation .
we found no published evaluations of collaborations between newspapers and scientists with the aim of increasing pa among readers .
thus , we started the project  from couch potato to half marathon runner in 14 weeks ,  which was a collaboration between a quality norwegian regional newspaper and the university of stavanger .
the participants were enrolled in an intensive lifestyle intervention program for untrained adults , and their goals were to become physically fit and run a half marathon ( 21.1  km ) after 14 weeks of training .
the newspaper aimed to reach a new group of readers by publishing the experiences of the participants in this intervention study and to inspire readers to change their lifestyles and become more physically active .
the main purpose of this study was to measure the response from readers regarding reports of untrained adults who participated in an individually designed lifestyle intervention program .
we also wanted to gain experience of this intervention method and to explore its possibilities to increase participation in lifestyle intervention programs .
the nature of exploratory research is to gain experience that will be helpful in expressing relevant hypothesis for more definite investigation .
the main challenge of the study was to intercept readers ' response to the newspaper articles during the intervention period , since this was unknown .
the newspaper wanted to collaborate with the university of stavanger to design an exercise program and train three sedentary adults .
the newspaper 's readers were asked to participate in the 14 weeks long intervention study .
the inclusion criteria were that participants had a body mass index between 25 and 35 , had to be capable of running a distance of 3,000  m in around 20  min , should not have any kind of knee or hips problems , and could not be engaged in regular endurance training .
a total of 169 adults ( 60% women ) aged 1774 asked to be included in the project .
in addition , a physiotherapist and a nutritional expert provided advice on alternative training and nutrition .
the participants were informed that they would become the focus of public interest because they would receive newspaper coverage every week during the project period .
the participants provided written informed consent that all the data related to their training and testing could be published in the newspaper and used in a scientific publication .
the daily circulation of the newspaper was 63,000 copies , with an estimated readership of around 180,000 ( three readers per copy ) . before intervention , the newspaper aimed to publish 2 - 3 articles per week about the project .
total amount of published articles ended at 48 , distributed equally throughout a period of 15 weeks and published both in the newspaper and on the project 's website .
twenty - two articles focused on the testing , training , and progression of the three participants .
seven articles focused on exercise training principles , three articles on nutrition , and four articles on pa and health .
five of the articles focused on a mix of two or more of the mentioned topics .
every friday , the training program for the coming week was published in the newspaper and on the newspaper 's website .
the number of hits on the project 's website was registered throughout the project period .
the maximal oxygen uptake ( vo2max ) of the participants was measured at the start and after 13 weeks of training using a vmax 29 oxygen analyzer ( sensormedics , yorba linda , ca , usa ) . a treadmill ( elg 2 ; woodway gmbh , weil am rhein , germany )
the three participants completed a 3,050  m running test around a lake at baseline and after 13 weeks of training .
the 14-week training program was based on elite runners training principles , which consisted of a weekly mixture of two intensive interval sessions at 90% of hrmax and two continuous running sessions at moderate and low intensity . during the first three training weeks ,
the effective running time for the interval sessions was 15 - 16  min , that is , 8 times 2-minute jog at a heart rate of about 90% of hrmax with 1  min walk recovery .
after five weeks , the effective running period during the interval sessions was increased to 2024  min .
the continuous sessions started with one running session of 20  min and the other session as a combination of 40  min of walking and running .
after week 5 , the longest continuous running sessions were increased by 10  min each week until the participants could complete 100  min of continuous running .
the lead journalist on the project also received an average of 15 questions or comments each week from readers by e - mail .
the newspaper invited readers to engage in six different internet debates about training , pa , nutrition , and other health issues . between 20 and 35 questions from the readers
, readers were invited to join an open and supervised interval training session with the three project participants .
first , the participants in the three open interval training sessions established a weekly running group .
one year after the end of the project , 3060 participants aged 1573 ( 70% women ) still met twice each week for an interval running session .
a total of 90 different individuals participated in one or more of these training sessions .
this newspaper followed three untrained adults whose goal was to complete a 41  km cross - country skiing competition , the  hovden tour ,  after 11 weeks of training . over 390 readers asked to participate in this project .
two double - page articles were published in the newspaper 's sport pages each week during the project period . on three occasions ,
seventy individuals participated in the first running session , but the number of participants was limited to 60 in two subsequent technical skiing sessions .
the cross - country competition , the  hovden tour ,  was arranged for the first time in the project year .
 three lakes race ,  which was the half marathon race the three participants competed in , was organized for the sixth time during the project year ( 2011 ) .
the number of runners who finished the race gradually increased from 150 in the first year ( 2006 ) to 460 in 2009 . in the year prior to the project year ( 2010 ) , the number of runners who completed the race was 450 .
in the project year , the number of competitors who completed the race was 937 .
in the two previous years , there was also a relay class in the race .
the number of teams increased from 11 in 2010 to 28 in the project year . throughout 13 weeks of training
, all participants experienced a significant increase in their vo2max , a reduction in their bmi , and an improvement in the running test ( table 1 ) .
after seven weeks , they competed in a 10  km road race , and they achieved the following running times : 1:05:14 hour : min : s ( female 1 or f1 ) , 1:01:44 ( female 2 or f2 ) , and 1:02:07 ( male 1 or m1 ) .
all participants completed the half marathon race after 14 weeks of training , and they achieved the following times : 2:24:54 ( f1 ) , 2:20:18 ( f2 ) , and 2:15:30 ( m1 ) . in their respective age groups ,
the participants finished 160 of 172 ( f1 ) , 34 of 40 ( f2 ) , and 160 of 170 ( m1 ) .
the main findings of the study were that the press cover of the three former inactive participants , who achieved their goal of completing the half marathon race based on a 14-week - long lifestyle intervention program , resulted in 25,000 weekly unique hits at the project 's website .
the readers e - mailed questions , participated at internet debates and open training sessions , and established a weekly training group .
an important criterion for success was that the three participants achieved their goals during the lifestyle intervention period .
the participants told their stories through the newspaper , and the impact of the project was dependent on their achievements .
thus , great efforts were made to optimize their physical training programs and to increase the consciousness of participants about healthy lifestyle habits .
the male participant stated that this project was one of the best things that could have happened to him .
he reduced his body weight by 10  kg and normalized his total cholesterol level and blood pressure .
he continued to train four times each week after the project and aimed to participate in future endurance runs .
one of the female participants ( f1 ) was one of two coaches who established the running group after the project .
she now runs 2 - 3 weekly running sessions and cycles 20  km to and from her job twice each week .
it has a positive effect on my spirit and my level of energy , and i have enrolled for my next half marathon race .  the second female runner ( f2 ) had problems with her hips for several weeks throughout the project period . during this period ,
she began supervised strength training and replaced two of the running sessions with steep walking sessions on a treadmill ( 10% gradient ) .
the length and intensity of these sessions were the same as those in the recommended running sessions .
i have reduced my body weight by 10 kilograms as a result of changing my way of living , and my goal is to run another half marathon race in the near future . 
the story about her use of alternative training during the injury period was published in the newspaper , and it may have been helpful for others struggling with similar injury problems .
approximately 60% of the 90 participants in the running group , which was established after the open training sessions , had previously been regularly physically active for more than six months .
however , none of them had participated in systematic interval endurance training , and they experienced an improvement in their training quality in the running group .
twelve percent of the participants in the running group had previously not been regularly physically active , and they stated that they saw this open training invitation as a good opportunity to start exercising . to keep the running group motivated and to increase the number of participants , one of the two voluntary coaches sent a weekly e - mail to all 90 participants containing information about the next week 's training program and encouraging them to bring a friend .
a study by reed   showed that e - mail intervention campaigns can be successful in increasing the level of pa among women , so this initiative seemed entirely reasonable .
the running group received valuable publicity in newspaper reports , and this publicity was important for recruitment .
this training group has recently started a walking group since some of the new participants found running too hard and uncomfortable .
a norwegian study found that 76% of physically inactive subjects , that is , those who had not engaged in regular physical activity at least once every 14 days , wanted to engage in regular pa .
the majority of this group reported that they required more initiatives or greater motivation to change their pa habits .
the response to the present project was much greater than expected , and it showed that this type of intervention can provide the necessary motivation to increase pa .
the newspaper gave the project high priority with front - page covers and double - page articles .
the project received intensive coverage because of high interest among readers prior to the project . a reader survey of 1,000 newspaper readers
was conducted a short time before the project commenced and showed that 60% ( around 100,000 ) of the readers were interested in articles about pa , training , nutrition , and lifestyle .
it is reasonable to consider that the newspaper 's high level of project coverage increased interest among readers .
another important factor that affected involvement in the project was that the project period was sufficiently short to be attractive to readers but long enough to make the participants fit . a systematic review by foster et al
.   indicated that professional advice and guidance with continued support can encourage people to become more physically active in the short to medium term .
therefore , an improvement of the project would have been to provide more follow - up reports , for example , different exercise programs that focus on the maintenance of physical fitness articles , to maintain the interest and support of readers .
the idea of  training people for a better life  and publishing this in the media is not new .
this approach has been used in many reality shows and other health programs on television and in health magazines .
the publication of personal success stories also occurs on a large scale in commercial advertising .
the same principle was applied in the present study , and the large numbers of readers who followed the project showed that the subject was of great interest .
however , it is of great importance that readers were inspired to make lifestyle changes themselves and that they actually took steps to begin exercising
. we do not know how many of the new competitors in the local half marathon race ( the  three lakes race  ) were inspired to copy the three project participants . however , it is not unlikely that some of the increase in race participants could relate to the project  from couch potato to half marathon runner in 14 weeks .
 the transtheoretical model , which is also known as the stages of change model , could be useful for describing the pa level of readers affected by this project .
stage one would include the inactive readers who had not considered becoming more active , whereas inactive readers who wanted to be more active were included at stage two .
stage three included those who wanted to become physically active within one month , and many of these would already be engaged in some form of pa .
stage - four individuals had been regularly physically active for less than six months , whereas those who had been regularly physically active for more than six months were at stage five .
we did not determine the characteristics of new participants in the  three lakes race .
 however , the three project participants finished near the bottom of the results list .
so , despite the doubling of participants from the previous year , it is reasonable to consider that the new race participants were more physically fit than our project participants ; that is , they were likely to be defined to stage four or five in the transtheoretical model . based on the level of participation in the running group , it seems that this group may have been the attraction for people who were occasionally physically active but who wanted more structure in their physical training , which is typical for people at stages three and four .
however , the walking group , which was recently established , seems to recruit people from stage two .
the newspaper articles could have been important for raising awareness about pa and health , which is essential for people at stages one and two in the transtheoretical model .
thus , it seems reasonable to assume that this type of intervention strategy engaged people at stages two to five , although the main effects were on people at stages three and four .  
the cost of the intervention program for the three participants was around us$6,250 , which is high for only three people .
however , the project had an estimated 100,000 readers and 25,000 unique weekly hits on the website .
we also found that the number of participants in the half marathon race increased by around 500 , while 90 people joined the weekly running sessions .
thus , the price per participant was low after taking these figures into consideration , regardless of whether the cost was split among 90 , 500 , or 25,000 participants . an important factor for this kind of intervention is the collaboration with the press .
a public health department would probably have been incapable of conducting such a successful program on its own .
it would have been very expensive to pay for advertising containing 48 articles , most of which were double - paged and several front - page stories .
second , the level of interest may also have been lower if the project had been published as an advertisement in a newspaper .
several other regional newspapers also took an interest in the project , and one month after the end of our project the leading regional newspaper in kristiansand , the fifth - largest city in norway , started a similar project .
compared with the present study , twice as many readers asked to be included in the project . however ,
the lead journalist on the project said that they had reached a new segment of readers , and the large number of hits on the project 's web page confirmed that this type of reportage was of great interest .
women comprised over 50% of those who wanted to participate in the skiing project and those who joined the three public training sessions .
traditionally , less than 30% of the competitors in public norwegian cross - country skiing competitions are women .
the overrepresentation of women in the half marathon running project and the cross - country skiing project might suggest that this type of lifestyle intervention program appeals more to women . according to hagberg and lindholm ,
the main criteria for judging the success of a lifestyle intervention program are exercise efficacy , population penetration ( capacity to recruit participants ) , and adherence to pa .
first , we established a well - designed training program with personal trainers , a nutritional expert , and a physiotherapist .
we measured the physical fitness of the participants and detected significant improvements after the training period , while the participants reported highly positive experiences with this intensive and individually adapted intervention program .
second , the project received a lot of coverage in the newspaper , which ensured widespread publicity and increased the likelihood of recruiting participants .
third , only three of the 169 highly motivated applicants were included in the study , but the adherence to the program was 100% .
first , there was no control group for measuring the response of the readers to the project .
we could have conducted a survey of 1,000 readers and included questions on the possible effects of the study .
second , our estimate of 100,000 readers was based on a reader survey prior to the project and not during the project . however , the survey was carried out only two months before the start of the project .
third , we did not interview the new participants in the half marathon race to determine any possible link with the present project .
we therefore do not know how many of the new participants were inspired to start as a result of the newspapers project coverage .
a limitation or challenge with this type of intervention is that the general advice provided in a newspaper is not suitable for all readers .
it is not possible to provide individually tailored training programs , so the wrong type of activity and training duration / intensity could result in injuries .
there is high media interest in publishing health - related reportage , and this opportunity to motivate healthy lifestyles should be explored more intensively .
the study presents a new approach to increase participation in a high - cost lifestyle intervention program . from an international perspective
, this project has high potential for promoting public health via increased participation in pa .
for example , the newspaper usa today publishes 1.8 million copies each day , so the paper has around 5.4 million readers if we assume three readers per copy .
if this paper launched a similar project and received the same level of interest as the current study , almost three million readers might follow this lifestyle intervention program .
thus , there is great potential for recruiting participants to physical activity interventions by working with a newspaper or other large - scale media organizations .
a challenge is to ensure that major editorial desks are made aware of this opportunity to acquire new readers or viewers , and hopefully the present study can facilitate this type of collaboration .
 the study 's purpose was to measure the impact of an individually designed lifestyle intervention program on the readers of a regional newspaper . a newspaper with 180,000 daily readers covered a story about three untrained and overweight adults who participated in an individually designed lifestyle intervention program . 
 their goals were to become physically fit and run a half marathon ( 21.1  km ) after 14 weeks of training . 
 the newspaper published on average three weekly articles throughout the project period , including the weekly training program and a record of the physical improvements made by the participants . 
 the number of hits on the project 's web site was recorded . 
 spin - off effects on the responses of readers were mapped . 
 the project 's web site had 25,000 unique weekly hits . 
 significant spin - off effects included the establishment of training groups which were still active after two years and the launch of a similar project by another regional newspaper . 
 this individually designed lifestyle intervention program was successfully scaled up and reached a large number of the newspaper 's readers . 
 the collaboration between a newspaper and exercise researchers could also be adapted to other press media and represents a novel approach to improve participation in physical activities . 