A minority of published evidence -based PA interventions for adults with T2D were both effective and pragmatic for clinical implementation .
Although regular physical activity ( PA ) is a cornerstone of treatment for type 2 diabetes ( T2D ) , most adults with T2D are sedentary .
R and omized controlled trials ( RCTs ) have proven the effectiveness of PA behavioral interventions for adults with T2D but have rarely been conducted in healthcare setting s. We sought to identify PA interventions that are effective and practical to implement in clinical practice setting s. Our first aim was to use the valid Pragmatic-Explanatory Continuum Indicator Summary 2 ( PRECIS-2 ) tool to assess the potential for future implementation of PA interventions in clinical practice setting s. Our second aim was to identify interventions that effectively increased PA and glycemic control among the interventions in the top tertile of PRECIS-2 scores .
Comparative effectiveness of patient education methods for type 2 diabetes: a randomized controlled trial.
BACKGROUND Group education for patients with suboptimally controlled diabetes has not been rigorously studied . METHODS A total of 623 adults from Minnesota and New Mexico with type 2 diabetes and glycosylated hemoglobin ( HbA(1c ) ) concentrations of 7 % or higher were r and omized to ( 1 ) group education ( using the US Diabetes Conversation Map program ) , ( 2 ) individual education , or ( 3 ) usual care ( UC ; ie , no assigned education ) . Both education methods covered content as needed to meet national st and ards for diabetes self-management education and were delivered through accredited programs from 2008 to 2009 . General linear mixed-model methods assessed patient-level changes between treatment groups in mean HbA(1c ) levels from baseline to follow-up at 6.8 months . Secondary outcomes included mean change in general health status ( Medical Outcomes Study 12-Item Short Form Health Survey [ SF-12 ] ) , Problem Areas in Diabetes ( PAID ) , Diabetes Self-Efficacy ( DES-SF ) , Recommended Food Score ( RFS ) , and Physical Activity ( PA , min/wk ) . RESULTS Mean HbA(1c ) concentration decreased in all groups but significantly more with individual ( -0.51 % ) than group education ( -0.27 % ) ( P = .01 ) and UC ( -0.24 % ) ( P = .01 ) . The proportion of subjects with follow-up HbA(1c ) concentration lower than 7 % was greater for individual education ( 21.2 % ) than for group ( 13.9 % ) and UC ( 12.8 % ) ( P = .03 ) . Compared with UC , individual education ( but not group ) improved SF-12 physical component score ( + 1.88 ) ( P = .04 ) , PA ( + 42.95 min/wk ) ( P = .03 ) , and RFS ( + 0.63 ) ( P = .05 ) . Compared with group education , individual education reduced PAID ( -3.62 ) ( P = .02 ) and increased self-efficacy ( + 0.1 ) ( P = .04 ) . CONCLUSIONS Individual education for patients with established suboptimally controlled diabetes result ed in better glucose control outcomes than did group education using Conversation Maps . There was also a trend toward better psychosocial and behavioral outcomes with individual education . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00652509
A minority of published evidence -based PA interventions for adults with T2D were both effective and pragmatic for clinical implementation .
Although regular physical activity ( PA ) is a cornerstone of treatment for type 2 diabetes ( T2D ) , most adults with T2D are sedentary .
R and omized controlled trials ( RCTs ) have proven the effectiveness of PA behavioral interventions for adults with T2D but have rarely been conducted in healthcare setting s. We sought to identify PA interventions that are effective and practical to implement in clinical practice setting s. Our first aim was to use the valid Pragmatic-Explanatory Continuum Indicator Summary 2 ( PRECIS-2 ) tool to assess the potential for future implementation of PA interventions in clinical practice setting s. Our second aim was to identify interventions that effectively increased PA and glycemic control among the interventions in the top tertile of PRECIS-2 scores .