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Piras A, Raffi M. A Narrative Literature Review on the Role of Exercise Training in Managing Type 1 and Type 2 Diabetes Mellitus. Healthcare (Basel) 2023; 11:2947. [PMID: 37998439 PMCID: PMC10671220 DOI: 10.3390/healthcare11222947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
Diabetes mellitus (DM) is a metabolic disease characterized by chronic hyperglycemia associated with impaired carbohydrate, lipid, and protein metabolism, with concomitant absence of insulin secretion or reduced sensitivity to its metabolic effects. Patients with diabetes mellitus have a 30% more risk of developing heart failure and cardiovascular disease compared to healthy people. Heart and cardiovascular problems are the first cause of death worldwide and the main complications which lead to high healthcare costs. Such complications can be delayed or avoided by taking prescribed medications in conjunction with a healthy lifestyle (i.e., diet and physical activity). The American College of Sports Medicine and the American Diabetes Association recommend that diabetic people reduce total sedentary time by incorporating physical activity into their weekly routine. This narrative literature review aims to summarize and present the main guidelines, pre-exercise cardiovascular screening recommendations, and considerations for patients with diabetes and comorbidities who are planning to participate in physical activity programs.
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Affiliation(s)
- Alessandro Piras
- Department of Life Quality Studies, University of Bologna, 40126 Bologna, Italy
| | - Milena Raffi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
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Wurz A, Bean C, Shaikh M, Culos-Reed SN, Jung ME. From laboratory to community: Three examples of moving evidence-based physical activity into practice in Canada. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1690-e1700. [PMID: 34623004 DOI: 10.1111/hsc.13596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 08/12/2021] [Accepted: 09/20/2021] [Indexed: 06/13/2023]
Abstract
Physical activity (PA) is important for enhancing and sustaining people's health and well-being. Although a number of efficacious PA interventions have been developed, few have been translated from research into practice. Consequently, the knowledge-to-practice gap continues to grow, leaving many individuals unable to access evidence-based PA opportunities. This gap may be particularly relevant for those who grapple with poor health due to intrapersonal, interpersonal, cultural and system-level barriers that limit their access to evidence-based PA opportunities. Implementation efforts designed to bring research into real-world settings may bridge the knowledge-to-practice gap. Yet, cultivating quality partnerships and ensuring effectiveness, methodological rigour and scalability in real-world settings can be difficult. Furthermore, researchers seldom publish examples of how they addressed these challenges and translated their evidence-based PA opportunities into practice. Herein, we describe three cases of successful PA implementation among diverse populations: (a) individuals affected by cancer, (b) adults living with prediabetes, and (c) children from under-resourced communities. Commonalities across cases include guiding theories and frameworks, the strategies to facilitate and maintain partnerships, and scalability and sustainability plans. Practical tips and recommendations are provided to spur research and translation efforts that consider implementation from the outset, ultimately ensuring that people receive the benefits PA can confer.
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Affiliation(s)
- Amanda Wurz
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Corliss Bean
- Department of Recreation & Leisure Studies, Brock University, St. Catharines, Canada
| | - Majidullah Shaikh
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, The University of British Columbia, Kelowna, Canada
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Dineen TE, Bean C, Jung ME. Implementation of a diabetes prevention program within two community sites: a qualitative assessment. Implement Sci Commun 2022; 3:11. [PMID: 35123582 PMCID: PMC8817168 DOI: 10.1186/s43058-022-00258-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 01/18/2022] [Indexed: 11/30/2022] Open
Abstract
Background Despite numerous translations of diabetes prevention programs, implementation evaluations are rarely conducted. The purpose of this study was to examine the implementation process and multilevel contextual factors as an evidence-based diabetes prevention program was implemented into two local community organization sites to inform future scale-up. To build the science of implementation, context and strategies must be identified and explored to understand their impact. Methods The program was a brief-counseling diet and exercise modification program for individuals at risk of developing type 2 diabetes. A 1-year collaborative planning process with a local not-for-profit community organization co-developed an implementation plan to translate the program. A pragmatic epistemology guided this research. Semi-structured interviews were conducted with staff who delivered the program (n = 8), and a focus group was completed with implementation support staff (n = 5) at both community sites. Interviews were transcribed verbatim and thematically analyzed using a template approach. The consolidated framework for implementation research (CFIR) is a well-researched multilevel implementation determinant framework and was used to guide the analysis of this study. Within the template approach, salient themes were first inductively identified, then identified themes were deductively linked to CFIR constructs. Results Implementation strategies used were appropriate, well-received, and promoted effective implementation. The implementation plan had an impact on multiple levels as several CFIR constructs were identified from all five domains of the framework: (a) process, (b) intervention characteristics, (c) outer setting, (d) inner setting, and (e) individual characteristics. Specifically, results revealed the collaborative 1-year planning process, program components and structure, level of support, and synergy between program and context were important factors in the implementation. Conclusion This study offers insights into the process of implementing a community-based diabetes prevention program in two local sites. Successful implementation benefited from a fully engaged, partnered approach to planning, and subsequently executing, an implementation effort. The CFIR was a useful and thorough framework to evaluate and identify multilevel contextual factors impacting implementation. Results can be used to inform future implementation and scale-up efforts. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-022-00258-6.
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Affiliation(s)
- Tineke E Dineen
- School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, 3333 University Way, Kelowna, BC, V1V 1V7, Canada
| | - Corliss Bean
- Department of Recreational and Leisure Studies, Brock University, 1812 Sir Isaac Brock Way, St Catharines, ON, L2S 3A1, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, 3333 University Way, Kelowna, BC, V1V 1V7, Canada.
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Francois ME, Oetsch KM. Prediabetes: Challenges, Novel Solutions, and Future Directions. EUROPEAN MEDICAL JOURNAL 2022. [DOI: 10.33590/emj/21-00148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Prediabetes: Prediabetes is a salient state of hyperglycaemia and/or hyperinsulinaemia that often precedes a diagnosis of Type 2 diabetes (T2D). It is projected that by 2040, almost 8% of the global population will have prediabetes, with approximately 70% progressing to T2D within their lifetime. Abnormal glucose tolerance increases the risk of associated complications, including cardiovascular disease, stroke, and microvascular diseases, all of which are major contributors to the global healthcare burden. T2D alone is predicted to cost the healthcare system upwards of 490 billion USD by 2030, thus addressing this growing burden is vital.
Challenge One. Diagnosis and classification: Diagnosis poses a challenge and there is debate between leading world expert panels regarding thresholds, notably between the World Health Organization (WHO) and American Diabetes Association (ADA) for impaired fasting glucose. Hyperinsulinaemia may also go undetected as this is not currently routinely tested or used as diagnostic criteria. This has been largely due to cost and lack of consensus data for appropriate diagnostic threshold; however, with disease burden costs estimated to be close to half a billion USD by the end of the decade, an in-depth cost analysis for benefits-costs of early detection and treatment or prevention is warranted.
Challenge Two. Health messaging and public perception: Prediabetes can revert to normoglycaemia with diet and lifestyle interventions. This, however, is not conveyed well in public health messaging. In addition to public perception about the likelihood of disease progression to T2D, prediabetes is not considered a disease state, which may also influence public perception regarding perceived urgency of treatment and necessity for intervention.
Challenge Three. Intervention and treatment: Diet and lifestyle interventions are heralded as best practice when it comes to prediabetes management, and metformin for those at greatest risk of future T2D. Synergistic use of the available novel and promising interventions including low carbohydrate diets, higher protein diets, time restricted feeding, and high intensity interval training may help time-poor individuals achieve improvements in risk-factors including weight loss and glycaemic control (HbA1c and fasting plasma glucose). As large-scale feasibility and adherence are major obstacles to contend with in the rollout of diet and lifestyle interventions, personalised approaches, coupled with counselling based on social cognitive theory, may be increasingly utilised to target specific groups and individuals as programmes can be tailored to meet specific needs and preferences.
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Affiliation(s)
- Monique E Francois
- School of Medicine, University of Wollongong, Australia; Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Katie M Oetsch
- School of Medicine, University of Wollongong, Australia; Illawarra Health and Medical Research Institute, Wollongong, Australia
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“It’s a Life Thing, Not a Few Months Thing”: Profiling Patterns of the Physical Activity Change Process and Associated Strategies of Women With Prediabetes Over 1 Year. Can J Diabetes 2020; 44:701-710. [DOI: 10.1016/j.jcjd.2020.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 08/28/2020] [Accepted: 09/01/2020] [Indexed: 12/25/2022]
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Rockette-Wagner B, Fischer GS, Kriska AM, Conroy MB, Dunstan D, Roumpz C, McTigue KM. Efficacy of an Online Physical Activity Intervention Coordinated With Routine Clinical Care: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e18891. [PMID: 33141103 PMCID: PMC7671848 DOI: 10.2196/18891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 11/17/2022] Open
Abstract
Background Most adults are not achieving recommended levels of physical activity (150 minutes/week, moderate-to-vigorous intensity). Inadequate activity levels are associated with numerous poor health outcomes, and clinical recommendations endorse physical activity in the front-line treatment of obesity, diabetes, dyslipidemia, and hypertension. A framework for physical activity prescription and referral has been developed, but has not been widely implemented. This may be due, in part, to the lack of feasible and effective physical activity intervention programs designed to coordinate with clinical care delivery. Objective This manuscript describes the protocol for a pilot randomized controlled trial (RCT) that tests the efficacy of a 13-week online intervention for increasing physical activity in adult primary care patients (aged 21-70 years) reporting inadequate activity levels. The feasibility of implementing specific components of a physical activity clinical referral program, including screening for low activity levels and reporting patient program success to referring physicians, will also be examined. Analyses will include participant perspectives on maintaining physical activity. Methods This pilot study includes a 3-month wait-listed control RCT (1:1 ratio within age strata 21-54 and 55-70 years). After the RCT primary end point at 3 months, wait-listed participants are offered the full intervention and all participants are followed to 6 months after starting the intervention program. Primary RCT outcomes include differences across randomized groups in average step count, moderate-to-vigorous physical activity, and sedentary behavior (minutes/day) derived from accelerometers. Maintenance of physical activity changes will be examined for all participants at 6 months after the intervention start. Results Recruitment took place between October 2018 and May 2019 (79 participants were randomized). Data collection was completed in February 2020. Primary data analyses are ongoing. Conclusions The results of this study will inform the development of a clinical referral program for physical activity improvement that combines an online intervention with clinical screening for low activity levels, support for postintervention behavior maintenance, and feedback to the referring physician. Trial Registration ClinicalTrials.gov NCT03695016; https://clinicaltrials.gov/ct2/show/NCT03695016. International Registered Report Identifier (IRRID) DERR1-10.2196/18891
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Affiliation(s)
- Bonny Rockette-Wagner
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Gary S Fischer
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrea M Kriska
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Molly B Conroy
- Division of General Internal Medicine, University of Utah, Salt Lake City, UT, United States
| | - David Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Caroline Roumpz
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kathleen M McTigue
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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Santos A, Stork MJ, Locke SR, Jung ME. Psychological responses to HIIT and MICT over a 2-week progressive randomized trial among individuals at risk of type 2 diabetes. J Sports Sci 2020; 39:170-182. [PMID: 32881648 DOI: 10.1080/02640414.2020.1809975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this secondary analysis study was to examine the affective and social cognitive responses to low-volume high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) over a progressive two-week supervised intervention for individuals at risk of type 2 diabetes. Ninety-nine adults that were low-active and overweight were randomized into one of two exercise conditions and had affective and social cognitive measures assessed before, during, and after intervention. Increases over time in post-exercise enjoyment, attitudes towards exercise, and intentions to exercise were noted for both HIIT and MICT conditions (ps <.05). The patterns of change in acute affective responses over the two-week intervention were consistent for both conditions, with participants in MICT reporting more positive in-task affect and affective attitudes throughout (ps <.001). Positive correlational relationships between affective and social cognitive responses were revealed throughout the intervention (ps <.05), highlighting the relationship between reflexive responses and reflective cognitions. Research is warranted to determine whether findings are a consequence of familiarization with exercise, whether such findings are translatable to real-world environments and non-progressive exercise protocols, and whether these reflexive responses and reflective cognitions are predictive of future exercise behaviour for individuals at risk of type 2 diabetes.
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Affiliation(s)
- Alexandre Santos
- Faculty of Health and Social Development, University of British Columbia , Kelowna, British Columbia, Canada
| | - Matthew J Stork
- Faculty of Health and Social Development, University of British Columbia , Kelowna, British Columbia, Canada
| | - Sean R Locke
- Faculty of Health and Social Development, University of British Columbia , Kelowna, British Columbia, Canada
| | - Mary E Jung
- Faculty of Health and Social Development, University of British Columbia , Kelowna, British Columbia, Canada
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Bean C, Sewell K, Jung ME. A winning combination: Collaborating with stakeholders throughout the process of planning and implementing a type 2 diabetes prevention programme in the community. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:681-689. [PMID: 31795016 DOI: 10.1111/hsc.12902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/07/2019] [Accepted: 11/12/2019] [Indexed: 05/16/2023]
Abstract
Translation of efficacious health interventions into the community are often not applied in practice. The gap between research and practice is concerning for community members who can benefit from early access to effective health interventions. Knowledge translation activities and strong community partnerships are demonstrated methods to close the gap, yet there is a need to ensure research findings are implemented into communities in a way that yields quality programming and sustainability through planning, preparation and time to foster the partnership. This paper outlines the collaborative process of translating a successful, evidence-based diet and exercise diabetes prevention programme for improving health and exercise adherence into a community setting through the partnership between the Diabetes Prevention Research Group and YMCA of Okanagan within British Columbia, Canada. Initiated in 2017, the process involved formalised translation events and programme piloting enabling the team to work towards a successful partnership. Lessons learned and next steps in working collaboratively towards programme scale-up and sustainability are outlined.
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Affiliation(s)
- Corliss Bean
- Faculty of Health and Social Development, The University of British Columbia, Kelowna, British Columbia
| | | | - Mary E Jung
- Faculty of Health and Social Development, The University of British Columbia, Kelowna, British Columbia
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Jung ME, Locke SR, Bourne JE, Beauchamp MR, Lee T, Singer J, MacPherson M, Barry J, Jones C, Little JP. Cardiorespiratory fitness and accelerometer-determined physical activity following one year of free-living high-intensity interval training and moderate-intensity continuous training: a randomized trial. Int J Behav Nutr Phys Act 2020; 17:25. [PMID: 32102667 PMCID: PMC7045584 DOI: 10.1186/s12966-020-00933-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 02/14/2020] [Indexed: 02/01/2023] Open
Abstract
Background Free-living adherence to high-intensity interval training (HIIT) has not been adequately tested. This randomized trial examined changes in cardiorespiratory fitness (CRF) and accelerometer-measured purposeful physical activity over 12 months of free-living HIIT versus moderate-intensity continuous training (MICT). Methods Ninety-nine previously low-active participants with overweight/obesity were randomly assigned to HIIT (n = 47) or MICT (n = 52). Both interventions were combined with evidence-based behaviour change counselling consisting of 7 sessions over 2 weeks. Individuals in HIIT were prescribed 10 X 1-min interval-based exercise 3 times per week (totalling 75 min) whereas individuals in MICT were prescribed 150 min of steady-state exercise per week (50 mins 3 times per week). Using a maximal cycling test to exhaustion with expired gas analyses, CRF was assessed at baseline and after 6 and 12 months of free-living exercise. Moderate-to-vigorous physical activity of 10+ minutes (MVPA10+) was assessed by 7-day accelerometry at baseline, 3, 6, 9, and 12 months. Intention to treat analyses were conducted using linear mixed models. Results CRF was improved over the 12 months relative to baseline in both HIIT (+ 0.15 l/min, 95% CI 0.08 to 0.23) and MICT (+ 0.11 l/min, 95% CI 0.05 to 0.18). Both groups improved 12-month MVPA10+ above baseline (HIIT: + 36 min/week, 95% CI 17 to 54; MICT: + 69 min/week, 95% CI 49 to 89) with the increase being greater (by 33 min, 95% CI 6 to 60) in MICT (between group difference, P = 0.018). Conclusion Despite being prescribed twice as many minutes of exercise and accumulating significantly more purposeful exercise, CRF improvements were similar across 12 months of free-living HIIT and MICT in previously low-active individuals with overweight/obesity.
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Affiliation(s)
- M E Jung
- School of Health and Exercise Sciences Faculty of Health and Social Development, The University of British Columbia Okanagan, FHSD 3333 University Way ART360, Kelowna, BC, V1V 1V7, Canada.
| | - S R Locke
- School of Health and Exercise Sciences Faculty of Health and Social Development, The University of British Columbia Okanagan, FHSD 3333 University Way ART360, Kelowna, BC, V1V 1V7, Canada
| | | | - M R Beauchamp
- The University of British Columbia, Vancouver Campus, Vancouver, Canada
| | - T Lee
- The University of British Columbia, Vancouver Campus, Vancouver, Canada
| | - J Singer
- The University of British Columbia, Vancouver Campus, Vancouver, Canada
| | - M MacPherson
- School of Health and Exercise Sciences Faculty of Health and Social Development, The University of British Columbia Okanagan, FHSD 3333 University Way ART360, Kelowna, BC, V1V 1V7, Canada
| | - J Barry
- School of Health and Exercise Sciences Faculty of Health and Social Development, The University of British Columbia Okanagan, FHSD 3333 University Way ART360, Kelowna, BC, V1V 1V7, Canada
| | - C Jones
- School of Health and Exercise Sciences Faculty of Health and Social Development, The University of British Columbia Okanagan, FHSD 3333 University Way ART360, Kelowna, BC, V1V 1V7, Canada
| | - J P Little
- School of Health and Exercise Sciences Faculty of Health and Social Development, The University of British Columbia Okanagan, FHSD 3333 University Way ART360, Kelowna, BC, V1V 1V7, Canada
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MacPherson MM, Merry KJ, Locke SR, Jung ME. Effects of Mobile Health Prompts on Self-Monitoring and Exercise Behaviors Following a Diabetes Prevention Program: Secondary Analysis From a Randomized Controlled Trial. JMIR Mhealth Uhealth 2019; 7:e12956. [PMID: 31489842 PMCID: PMC6753687 DOI: 10.2196/12956] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 05/08/2019] [Accepted: 07/21/2019] [Indexed: 12/18/2022] Open
Abstract
Background A number of mobile health (mHealth) apps exist that focus specifically on promoting exercise behavior. To increase user engagement, prompts, such as text messages, emails, or push notifications, are often used. To date, little research has been done to understand whether, and for how long, these prompts influence exercise behavior. Objective This study aimed to assess the impact of prompts on mHealth self-monitoring and self-reported exercise in the days following a prompt and whether these effects differ based on exercise modality. Methods Of the possible 99 adults at risk for developing type II diabetes who participated in a diabetes prevention program, 69 were included in this secondary analysis. Participants were randomly assigned to 1 of the following 2 exercise conditions: high-intensity interval training or moderate-intensity continuous training. In the year following a brief, community-based diabetes prevention program involving counseling and supervised exercise sessions, all participants self-monitored their daily exercise behaviors on an mHealth app in which they were sent personalized prompts at varying frequencies. mHealth self-monitoring and self-reported exercise data from the app were averaged over 1, 3, 5, and 7 days preceding and following a prompt and subsequently compared using t tests. Results In the year following the diabetes prevention program, self-monitoring (t68=6.82; P<.001; d=0.46) and self-reported exercise (t68=2.16; P=.03; d=0.38) significantly increased in the 3 days following a prompt compared with the 3 days preceding. Prompts were most effective in the first half of the year, and there were no differences in self-monitoring or self-reported exercise behaviors between exercise modalities (P values >.05). In the first half of the year, self-monitoring was significant in the 3 days following a prompt (t68=8.61; P<.001; d=0.60), and self-reported exercise was significant in the 3 days (t68=3.7; P<.001; d=0.37), 5 days (t67=2.15; P=.04; d=0.14), and 7 days (t68=2.46; P=.02; d=0.15) following a prompt, whereas no significant changes were found in the second half of the year. Conclusions This study provides preliminary evidence regarding the potential influence of prompts on mHealth self-monitoring and self-reported exercise and the duration for which prompts may be effective as exercise behavior change tools. Future studies should determine the optimal prompting frequency for influencing self-reported exercise behaviors. Optimizing prompt frequency can potentially reduce intervention costs and promote user engagement. Furthermore, it can encourage consumers to self-monitor using mHealth technology while ensuring prompts are sent when necessary and effective. International Registered Report Identifier (IRRID) DERR2-10.2196/11226
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Affiliation(s)
- Megan M MacPherson
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Kohle J Merry
- Mechatronic Systems Engineering, School of Engineering Science, Simon Fraser University, Surrey, BC, Canada
| | - Sean R Locke
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
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Bourne JE, Ivanova E, Gainforth HL, Jung ME. Mapping behavior change techniques to characterize a social cognitive theory informed physical activity intervention for adults at risk of type 2 diabetes mellitus. Transl Behav Med 2019; 10:705-715. [DOI: 10.1093/tbm/ibz008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Abstract
Behavior change techniques (BCTs) are used to target theoretical mechanisms of action predicted to bring about behavior change. Reporting BCTs and connecting them to mechanisms of action is critical to understanding intervention processes of change. This article identifies the BCTs associated with an exercise intervention for individuals at risk of type 2 diabetes and determines the extent to which these BCTs target associated mechanisms of action. BCTs were mapped onto social cognitive theory (SCT) and the theoretical domains framework (TDF) using published literature identifying links between BCTs and SCT/TDF and expert consensus. Two coders then used the 93-item BCT taxonomy (BCTTv1) to independently code BCTs within the intervention. The BCTs used in the current intervention enabled identification of the theoretical mechanisms of action targeted in the intervention. More than 70% of the intervention content incorporated at least one BCT. More than 50% of the BCTs used targeted SCT constructs and more than 70% of BCTs used targeted at least one of the 14 TDF domains. Five BCTs did not map onto either SCT or TDF. This research provides a systematic method of linking BCTs to mechanisms of action. This process increases the transparency of intervention content and identification of the mechanisms of action targeted in the current intervention. Reporting interventions in this manner will enable the most potent mechanisms of actions associated with long-term behavior change to be identified and utilized in future work.
Trial Registration: ClinicalTrials.gov # NCT02164474. Registered on June 12, 2014.
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Affiliation(s)
- Jessica E Bourne
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, Bristol, UK
| | - Elena Ivanova
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada
| | - Heather L Gainforth
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada
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