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 goal setting in diabetes mellitus group clinics: randomized clinical trial.
BACKGROUND  Diabetes mellitus ( DM ) group clinics  can effectively control hypertension , but data to support glycemic control are equivocal . This study evaluated the comparative effectiveness of 2 DM group clinic interventions on glycosylated hemoglobin ( HbA(1c ) ) levels in primary care . METHODS Eighty-seven participants were recruited from a DM registry of a single regional Veterans Affairs medical center to participate in an open , r and omized comparative effectiveness study . Two primary care-based DM group interventions of 3 months ' duration were compared . Empowering Patients in Care ( EPIC ) was a clinician-led , patient-centered group clinic consisting of 4 sessions on setting self-management action plans ( diet , exercise , home monitoring , medications , etc ) and communicating about progress with action plans . The comparison intervention consisted of group education sessions with a DM educator and dietician followed by an additional visit with one 's primary care provider .  Hemoglobin A(1c ) levels were compared after intervention and at the 1-year follow-up . RESULTS Participants in the EPIC intervention had significantly greater improvements in HbA(1c ) levels immediately following the active intervention ( 8.86%-8.04 % vs 8.74%-8.70 % of total hemoglobin ; mean [ SD ] between-group difference 0.67 % [ 1.3 % ] ; P=.03 ) , and these differences persisted at the 1 year follow-up ( 0.59 % [ 1.4 % ] , P=.05 ) . A repeated- measures analysis using all study time points found a significant time-by-treatment interaction effect on HbA(1c ) levels favoring the EPIC intervention ( F(2,85)=3.55 ; P=.03 ) . The effect of the time-by-treatment interaction seems to be partially mediated by DM self-efficacy ( F(1,85)=10.39 ; P=.002 ) . CONCLUSION Primary care-based DM group clinics that include structured goal - setting approaches to self-management can significantly improve HbA(1c ) levels after intervention and maintain improvements for 1 year . Trial Registration clinical trials.gov Identifier : NCT00481286
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 .