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Living Well with Diabetes: a randomized controlled trial of a telephone-delivered intervention for maintenance of weight loss, physical activity and glycaemic control in adults with type 2 diabetes.

Eakin EG, Reeves MM, Marshall AL, Dunstan DW, Graves N, Healy GN, Bleier J, Barnett AG, O'Moore-Sullivan T, Russell A, Wilkie K - BMC Public Health (2010)

Bottom Line: Incremental cost-effectiveness will also be examined.The evaluation of maintenance outcomes (6 months following the end of intervention), the use of accelerometers to objectively measure physical activity, and the inclusion of a cost-effectiveness analysis will advance the science of broad reach approaches to weight control and health behaviour change, and will build the evidence base needed to advocate for the translation of this work into population health practice.ACTRN12608000203358.

View Article: PubMed Central - HTML - PubMed

Affiliation: The University of Queensland, Level 3 Public Health Building, School of Population Health, Cancer Prevention Research Centre, Herston Road, Herston, QLD, Australia. e.eakin@sph.uq.edu.au.

ABSTRACT

Background: By 2025, it is estimated that approximately 1.8 million Australian adults (approximately 8.4% of the adult population) will have diabetes, with the majority having type 2 diabetes. Weight management via improved physical activity and diet is the cornerstone of type 2 diabetes management. However, the majority of weight loss trials in diabetes have evaluated short-term, intensive clinic-based interventions that, while producing short-term outcomes, have failed to address issues of maintenance and broad population reach. Telephone-delivered interventions have the potential to address these gaps.

Methods/design: Using a two-arm randomised controlled design, this study will evaluate an 18-month, telephone-delivered, behavioural weight loss intervention focussing on physical activity, diet and behavioural therapy, versus usual care, with follow-up at 24 months. Three-hundred adult participants, aged 20-75 years, with type 2 diabetes, will be recruited from 10 general practices via electronic medical records search. The Social-Cognitive Theory driven intervention involves a six-month intensive phase (4 weekly calls and 11 fortnightly calls) and a 12-month maintenance phase (one call per month). Primary outcomes, assessed at 6, 18 and 24 months, are: weight loss, physical activity, and glycaemic control (HbA1c), with weight loss and physical activity also measured at 12 months. Incremental cost-effectiveness will also be examined. Study recruitment began in February 2009, with final data collection expected by February 2013.

Discussion: This is the first study to evaluate the telephone as the primary method of delivering a behavioural weight loss intervention in type 2 diabetes. The evaluation of maintenance outcomes (6 months following the end of intervention), the use of accelerometers to objectively measure physical activity, and the inclusion of a cost-effectiveness analysis will advance the science of broad reach approaches to weight control and health behaviour change, and will build the evidence base needed to advocate for the translation of this work into population health practice.

Trial registration: ACTRN12608000203358.

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Related in: MedlinePlus

Chronic Disease Self-Management Intervention Model.
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Figure 1: Chronic Disease Self-Management Intervention Model.

Mentions: Intervention delivery is guided by a patient-centred, chronic disease self-management intervention model used in previous trials (Figure 1) [37,71], and by techniques of motivational interviewing [70]. An iterative process is used in each call: it draws upon repeated assessment of study outcomes and participant self-monitoring; feedback is provided in relation to study targets for weight, dietary intake and physical activity, and consistent with a motivational interviewing approach, this feedback highlights the discrepancy between participant goals and their current health behaviours; collaborative goals for weight, physical activity and dietary change are set with the telephone counsellor, with an emphasis on achievability and measurability. Each intervention contact results in a behaviourally-specific Action Plan that specifies exactly what is to be done and when; barriers and supports are identified; confidence is assessed and problem-solving is discussed as necessary. These steps are repeated during intervention calls, with goals being adjusted as necessary.


Living Well with Diabetes: a randomized controlled trial of a telephone-delivered intervention for maintenance of weight loss, physical activity and glycaemic control in adults with type 2 diabetes.

Eakin EG, Reeves MM, Marshall AL, Dunstan DW, Graves N, Healy GN, Bleier J, Barnett AG, O'Moore-Sullivan T, Russell A, Wilkie K - BMC Public Health (2010)

Chronic Disease Self-Management Intervention Model.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2927539&req=5

Figure 1: Chronic Disease Self-Management Intervention Model.
Mentions: Intervention delivery is guided by a patient-centred, chronic disease self-management intervention model used in previous trials (Figure 1) [37,71], and by techniques of motivational interviewing [70]. An iterative process is used in each call: it draws upon repeated assessment of study outcomes and participant self-monitoring; feedback is provided in relation to study targets for weight, dietary intake and physical activity, and consistent with a motivational interviewing approach, this feedback highlights the discrepancy between participant goals and their current health behaviours; collaborative goals for weight, physical activity and dietary change are set with the telephone counsellor, with an emphasis on achievability and measurability. Each intervention contact results in a behaviourally-specific Action Plan that specifies exactly what is to be done and when; barriers and supports are identified; confidence is assessed and problem-solving is discussed as necessary. These steps are repeated during intervention calls, with goals being adjusted as necessary.

Bottom Line: Incremental cost-effectiveness will also be examined.The evaluation of maintenance outcomes (6 months following the end of intervention), the use of accelerometers to objectively measure physical activity, and the inclusion of a cost-effectiveness analysis will advance the science of broad reach approaches to weight control and health behaviour change, and will build the evidence base needed to advocate for the translation of this work into population health practice.ACTRN12608000203358.

View Article: PubMed Central - HTML - PubMed

Affiliation: The University of Queensland, Level 3 Public Health Building, School of Population Health, Cancer Prevention Research Centre, Herston Road, Herston, QLD, Australia. e.eakin@sph.uq.edu.au.

ABSTRACT

Background: By 2025, it is estimated that approximately 1.8 million Australian adults (approximately 8.4% of the adult population) will have diabetes, with the majority having type 2 diabetes. Weight management via improved physical activity and diet is the cornerstone of type 2 diabetes management. However, the majority of weight loss trials in diabetes have evaluated short-term, intensive clinic-based interventions that, while producing short-term outcomes, have failed to address issues of maintenance and broad population reach. Telephone-delivered interventions have the potential to address these gaps.

Methods/design: Using a two-arm randomised controlled design, this study will evaluate an 18-month, telephone-delivered, behavioural weight loss intervention focussing on physical activity, diet and behavioural therapy, versus usual care, with follow-up at 24 months. Three-hundred adult participants, aged 20-75 years, with type 2 diabetes, will be recruited from 10 general practices via electronic medical records search. The Social-Cognitive Theory driven intervention involves a six-month intensive phase (4 weekly calls and 11 fortnightly calls) and a 12-month maintenance phase (one call per month). Primary outcomes, assessed at 6, 18 and 24 months, are: weight loss, physical activity, and glycaemic control (HbA1c), with weight loss and physical activity also measured at 12 months. Incremental cost-effectiveness will also be examined. Study recruitment began in February 2009, with final data collection expected by February 2013.

Discussion: This is the first study to evaluate the telephone as the primary method of delivering a behavioural weight loss intervention in type 2 diabetes. The evaluation of maintenance outcomes (6 months following the end of intervention), the use of accelerometers to objectively measure physical activity, and the inclusion of a cost-effectiveness analysis will advance the science of broad reach approaches to weight control and health behaviour change, and will build the evidence base needed to advocate for the translation of this work into population health practice.

Trial registration: ACTRN12608000203358.

Show MeSH
Related in: MedlinePlus