Hybrid Evaluation of a Lifestyle Change Program to Prevent the Development of Type 2 Diabetes Among Individuals With Prediabetes: Intended and Observed Changes in Intervening Mechanisms.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: Sage Publications Country of Publication: United States NLM ID: 101518419 Publication Model: Print Cited Medium: Internet ISSN: 2150-1327 (Electronic) Linking ISSN: 21501319 NLM ISO Abbreviation: J Prim Care Community Health Subsets: MEDLINE
    • Publication Information:
      Original Publication: Thousand Oaks, CA : Sage Publications
    • Subject Terms:
      Diabetes Mellitus, Type 2*/prevention & control ; Prediabetic State*/therapy ; Self Efficacy*; Humans ; Male ; Female ; Middle Aged ; Life Style ; Aged ; Adult ; Stress, Psychological/prevention & control ; Exercise ; Program Evaluation ; Affect ; Risk Reduction Behavior ; Primary Health Care ; Overweight/prevention & control ; Overweight/therapy
    • Abstract:
      Background: Lifestyle interventions can prevent type 2 diabetes (T2D) by successfully inducing behavioral changes (eg, avoiding physical inactivity and sedentariness, increasing physical activity and/or healthy eating) that reduce body weight and normalize metabolic levels (eg, HbA1c). For interventions to be successful, it is important to influence "behavioral mechanisms" such as self-efficacy, which motivate behavioral changes. Theory-based expectations of how self-efficacy, chronic stress, and mood changed over time were investigated through a group-based behavior change intervention (PREMIT). At 8 intervention sites, PREMIT was offered by trained primary care providers in 18 group-sessions over a period of 36 months, divided into 4 intervention phases. Adherence to the intervention protocol was assessed.
      Method: Participants (n = 962) with overweight and prediabetes who had achieved ≥8% weight loss during a diet reduction period and completed the intervention were categorized into 3 groups: infrequent, frequent, or very frequent group sessions attendance. The interactions between participation in the group sessions and changes in self-efficacy, stress, and mood were multivariate tested. Intervention sites were regularly asked where and how they deviated from the intervention protocol.
      Results: There was no increase in the participants' self-efficacy in any group. However, the level of self-efficacy was maintained among those who attended the group sessions frequently, while it decreased in the other groups. For all participants, chronic stress and the frequency of attending group sessions were inversely related. Significant differences in mood were found for all groups. All intervention centers reported specific activities, additional to intervention protocol, to promote participation in the group sessions.
      Conclusions: The results suggest that the behavioral changes sought by trained primary care providers are related to attendance frequency and follow complex trajectories. The findings also suggest that group-based interventions in naturalistic primary care settings aimed at preventing T2D require formats and strategies that encourage participants to attend group sessions regularly.
      Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Anne Raben has received honorariums from Nestlé, the International Sweeteners Association and Unilever. Pia Siig Vestentoft has received travel grants from the Cambridge Weight Plan, UK. Ian Macdonald was a member of the UK Government Scientific Advisory Committee on Nutrition, Treasurer of the Federation of European Nutrition Societies, Treasurer of the World Obesity Federation, member of the Mars Scientific Advisory Council, member of the Mars Europe Nutrition Advisory Board and Scientific Adviser to the Waltham Centre for Pet Nutrition. He was also a member of the Nestle Research Scientific Advisory Board and of the Novozymes Scientific Advisory Board. Jennie Brand-Miller is President and Director of the Glycemic Index Foundation, oversees a glycaemic index testing service at the University of Sydney and is a co-author of books about diet and diabetes. Sally Poppitt was the Fonterra Chair in Human Nutrition and Principle Investigator for NZ National Science Challenge High Value Nutrition during the PREVIEW intervention. Thomas Meinert Larsen is advisor for the “Sense” diet program. J. Alfredo Martinez is President of IUNS. All other authors have no conflicts of interest to declare.
    • Contributed Indexing:
      Keywords: adherence; behavior change; chronic stress; mood; prediabetes; self-efficacy
    • Publication Date:
      Date Created: 20240625 Date Completed: 20240625 Latest Revision: 20240625
    • Publication Date:
      20240625
    • Accession Number:
      10.1177/21501319241248223
    • Accession Number:
      38916158