The Alberta Diabetes and Physical Activity Trial (ADAPT):A Randomized Trial Evaluating Theory-Based Interventions to Inc
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ORIGINAL ARTICLE
The Alberta Diabetes and Physical Activity Trial (ADAPT): A Randomized Trial Evaluating Theory-Based Interventions to Increase Physical Activity in Adults with Type 2 Diabetes R. C. Plotnikoff, PhD & N. Karunamuni, MSc & K. S. Courneya, PhD & R. J. Sigal, MD, MPH & J. A. Johnson, PhD & S. T. Johnson, PhD Published online: 25 August 2012 # The Society of Behavioral Medicine 2012
Abstract Background Physical activity (PA) is associated with reduced morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM); however, most T2DM adults are insufficiently active. Purpose To explore the effectiveness of two innovative/ theoretically based behavioral-change strategies to increase PA and reduce hemoglobin A1c (A1c) in T2DM adults. Methods Participants (n0287) were randomly assigned to a control group or an intervention group (i.e., print-based materials/pedometer group or print-based materials/pedometer plus telephone-counseling group). Changes in PA and A1c and other clinical measures were examined by Linear
R. C. Plotnikoff (*) Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia e-mail: [email protected] N. Karunamuni : J. A. Johnson School of Public Health, University of Alberta, Edmonton, Alberta, Canada K. S. Courneya Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada R. J. Sigal Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada S. T. Johnson Centre for Nursing and Health Studies, Athabasca University, Athabasca, Alberta, Canada
Mixed Model analyses over 18 months, along with moderating effects for gender and age. Results PA and A1c levels did not significantly change in intervention groups. Step counts significantly increased in the print-based materials and pedometer plus telephone counseling group, for women. Conclusions No significant effects were found for PA or A1c levels for T2DM adults. The multi-component strategy including telephone counseling may have potential for women. The trial was registered on ClinicalTrials.gov identifier: NCT00221234. Keywords Diabetes . Physical activity . Intervention . Theory-based
Introduction The World Health Organization (WHO) estimates that more than 220 million people worldwide have diabetes [1]. Among individuals with type 2 diabetes mellitus (T2DM), participation in regular physical activity (PA) has been linked to improved blood glucose control [2–6], reduced progression of diabetic neuropathy [7], cardiovascular disease risk [8], and all-cause mortality [9, 10]. In spite of these benefits, current estimates indicate the majority of adults with T2DM remain either sedentary or insufficiently active to achieve health benefits [11, 12]. Several recent randomized trials have demonstrated that supervised, facility-based exercise training improves glycemic control and other cardiovascular risk factors in adults with T2DM [13–15]. However, such programs are often resource-intensive, only ava
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