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Promoting and maintaining physical activity in people with type 2 diabetes [with consumer summary]
Kirk AF, Mutrie N, Macintyre PD, Fisher MB
American Journal of Preventive Medicine 2004 Nov;27(4):289-296
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Limited research has investigated how to promote physical activity in people with type 2 diabetes. This study evaluated physical activity counseling over 12 months in people with type 2 diabetes. DESIGN: Participants were given standard exercise information and randomly assigned to receive physical activity counseling or not. Data were collected from September 2000 through to September 2002 and analyzed from October 2002 to February 2003. SETTING/PARTICIPANTS: Diabetes outpatient clinic. Seventy inactive people with type 2 diabetes. INTERVENTION: Physical activity counseling, based on the transtheoretical model, combined motivational theory and cognitive behavioral strategies into an individualized intervention to promote physical activity. Consultations were delivered at baseline and 6 months, with phone calls at 1 and 3 months post-consultation. MAIN OUTCOME MEASURES: Changes from baseline at 12 months in physical activity (7-day recall and accelerometer), stages and processes of exercise behavior change. RESULTS: Between-group differences were recorded in physical activity (recall and accelerometer) at 12 months (p < 0.01). Experimental participants significantly increased total activity (median difference 115 minutes; 95% confidence interval (CI) 73 to 150 minutes). Control participants recorded no significant change (median difference -15 minutes; 95% CI -53 to 13 minutes). The accelerometer experimental participants recorded no significant change (mean difference 416,632 counts; 95% CI -27,743 to 1,051,007 counts/week), while control participants recorded a significant decrease (mean difference -669,061 counts; 95% CI -1,292,285 to -45,837 counts/week). At 12 months, more experimental participants compared to controls were in active stages of behavior (6-month Chi2 = 26.4, p < 0.01; 12-month Chi2 = 19.9, p < 0.01, respectively). Between-group differences were recorded at 12 months for the frequency of using all processes (p < 0.01), except dramatic relief and stimulus control. CONCLUSIONS: Physical activity counseling was effective for promoting physical activity over 12 months in people with type 2 diabetes.

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