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Walking Away from Type 2 Diabetes: a cluster randomised controlled trial

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journal contribution
posted on 31.01.2017, 12:10 by Thomas Yates, Charlotte L. Edwardson, Joseph Henson, Laura J. Gray, Nuzhat B. Ashra, Jacqui Troughton, Kamlesh Khunti, Melanie Davies
Aims: This study aimed to investigate whether an established behavioural intervention, Walking Away from Type 2 Diabetes, is effective at promoting and sustaining increased walking activity when delivered within primary care. Methods: Cluster randomized controlled trial involving 10 general practices recruited from Leicestershire, UK, in 2009–2010. Eight hundred and eight (36% female) individuals with a high risk of Type 2 diabetes mellitus, identified through a validated risk score, were included. Participants in five practices were randomized to Walking Away from Type 2 Diabetes, a pragmatic 3-h group-based structured education programme incorporating pedometer use with annual follow-on refresher sessions. The primary outcome was accelerometer assessed ambulatory activity (steps/day) at 12 months. Longer term maintenance was assessed at 24 and 36 months. Results were analysed using generalized estimating equation models, accounting for clustering. Results: Complete accelerometer data for the primary outcome were available for 571 (71%) participants. Increases in ambulatory activity of 411 steps/day [95% confidence interval (CI): 117, 704] and self-reported vigorous-intensity physical activity of 218 metabolic equivalent min/week (95% CI: 6, 425) at 12 months were observed in the intervention group compared with control; differences between groups were not sustained at 36 months. No differences between groups were observed for markers of cardiometabolic health. Replacing missing data with multiple imputation did not affect the results. Conclusions: A pragmatic low-resource group-based structured education programme with pedometer use resulted in modest increases in ambulatory activity compared with control conditions after 12 months when implemented within a primary care setting to those at high risk of Type 2 diabetes mellitus; however, the results were not maintained over 36 months.

History

Citation

Diabetic Medicine, 2016.

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciences

Version

AM (Accepted Manuscript)

Published in

Diabetic Medicine

Publisher

Wiley for Diabetes UK

issn

0742-3071

eissn

1464-5491

Acceptance date

31/08/2016

Copyright date

2016

Available date

19/10/2017

Publisher version

http://onlinelibrary.wiley.com/doi/10.1111/dme.13254/abstract

Notes

The file associated with this record is embargoed until 12 months after the date of publication. The final published version may be available through the links above.

Language

en

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