TY - JOUR
T1 - Hybrid Evaluation of a Lifestyle Change Program to Prevent the Development of Type 2 Diabetes Among Individuals With Prediabetes
T2 - Intended and Observed Changes in Intervening Mechanisms
AU - Huttunen-Lenz, Maija
AU - Hansen, Sylvia
AU - Raben, Anne
AU - Westerterp-Plantenga, Margriet
AU - Adam, Tanja
AU - Macdonald, Ian
AU - Stratton, Gareth
AU - Swindell, Nils
AU - Martinez, J. Alfredo
AU - Navas-Carretero, Santiago
AU - Handjieva-Darlenska, Teodora
AU - Handjiev, Svetoslav
AU - Poppitt, Sally D.
AU - Silvestre, Marta P.
AU - Larsen, Thomas Meinert
AU - Vestentoft, Pia Siig
AU - Fogelholm, Mikael
AU - Jalo, Elli
AU - Brand-Miller, Jennie
AU - Muirhead, Roslyn
AU - Schlicht, Wolfgang
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - adherence
KW - behavior change
KW - chronic stress
KW - mood
KW - prediabetes
KW - self-efficacy
U2 - 10.1177/21501319241248223
DO - 10.1177/21501319241248223
M3 - Journal article
C2 - 38916158
AN - SCOPUS:85196991822
VL - 15
SP - 1
EP - 11
JO - Journal of Primary Care and Community Health
JF - Journal of Primary Care and Community Health
SN - 2150-1319
ER -