Determinants of Readiness for Adopting Healthy Lifestyle Behaviors Among Indigenous Adolescents with Type 2 Diabetes in Manitoba, Canada: A Cross‐Sectional Study

McGavock, Jonathan; Durksen, Anita; Wicklow, Brandy; Malik, Sayma; Sellers, Elizabeth; Blydt-Hansen, Tom; Château, Dan; Dart, Allison

doi:10.1002/oby.22148

Cited by 18 publications

(26 citation statements)

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“…Our findings are consistent with the existing literature regarding the challenges faced when intervening on adolescent's health behaviors, though there are several new pieces of knowledge that can be gleaned from the current analyses. Interventions to date most often report that changes in individual diet and activity behaviors may occur within the first few months (3‐6 months) of the intervention, but are not sustained a year or two later . However, such findings are limited by examining behaviors individually; consideration of an individual's patterns of both healthy and unhealthy diet and activity may be more sensitive to evaluating change due to intervention.…”

Section: Discussionsupporting

confidence: 89%

“…This could be possibly due to the adolescent's readiness to adopt lifestyle behaviors at one data collection interval vs the next. A study examining readiness to adopt healthy lifestyle changes in adolescents with T2D found that only 14% of their participants reported being “ready” to adopt such changes . This finding may shed light on the issue that examining behaviors in isolation may be a limitation of existing methods to examine the full impact of lifestyle changes on health outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Many individual health behaviors (ie, poor eating habits and sedentary lifestyle) have been linked to insulin resistance and T2D but, to our knowledge, the health behavior profiles of adolescents with T2D have not been fully described. Changing lifestyle behaviors in adolescents with T2D has been reported as extremely difficult due to both poor compliance and their lack of readiness for adopting healthy behaviors, especially in older adolescent populations . Unfortunately, when changes are made in diet and activity behaviors, the changes most often occur in the first few months (3‐6 months) of the intervention and are not sustained 1 to 2 years later .…”

Section: Introductionmentioning

confidence: 99%

“…Changing lifestyle behaviors in adolescents with T2D has been reported as extremely difficult due to both poor compliance and their lack of readiness for adopting healthy behaviors, especially in older adolescent populations . Unfortunately, when changes are made in diet and activity behaviors, the changes most often occur in the first few months (3‐6 months) of the intervention and are not sustained 1 to 2 years later . Trials evaluating lifestyle behaviors alone for the treatment of hyperglycemia in adolescent populations do not exist .…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the longitudinal change in health behavior profiles across treatment groups in the TODAY clinical trial

et al. 2020

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Background: Individual health behaviors (ie, eating habits and sedentary lifestyle) are associated with type 2 diabetes (T2D). Health behavior profiles specific to adolescents with T2D have not been described.Objective: To identify health behavior profiles in adolescents with T2D and examine how these profiles change over time.Methods: Diet (via food frequency questionnaire) and activity behaviors (via 3-day physical activity recall) examined at baseline, 6 months, and 24 months from participants in the the Treatment Options for T2D in Adolescents and Youth (TODAY) study were used for this analysis. Latent profile analysis identified profiles of health behaviors within three time points, and latent transition probabilities were estimated to examine the change from baseline to 6 months (n = 450) and baseline to 24 months (n = 415). Multinomial logistic regressions were used to examine if the assigned TODAY treatment group (Metformin [Met], Met + Rosiglitazone [Rosi], or Met + Lifestyle) predicted change in health behavior profiles.Results: Three profiles emerged: "most sedentary," "healthy eaters," and "active and eat most." At 6 months, 50% of males and 29% of females in the Met + Lifestyle treatment group improved in their health behavior profile. Among males only, the Met + Lifestyle treatment group were more likely to improve their profiles from baseline to 6 months (P = .01).Conclusions: Three health behavior profiles emerged and shifted over time. A high quality, lifestyle intervention had little effect on improving health behavior profiles.Optimizing outcomes in youth with T2D might require more robust and multifaceted interventions beyond family-level lifestyle, including more extensive psychosocial intervention, novel medication regimen, or bariatric surgery. K E Y W O R D Sadolescence, health behaviors, obesity, profiles, type 2 diabetesThe details of the TODAY study have been previously published. 14,15 The main objective of the original study was to examine the relative efficacy of three treatments: (a) Metformin (Met), (b) Met + Rosiglitazone (Rosi), and (c) Met + Lifestyle. Standard education wasgiven to all groups. The TODAY lifestyle program (TLP) was a familybased behavioral lifestyle change intervention that targeted weight loss. 16 TLP was developed to give the adolescents with T2D and their families intensive, ongoing support, and training in the behavioral skills needed for weight loss and maintenance. Each family was assigned a Personal Activity and Nutrition Leader (PAL) who met with the family weekly for the first 6 to 8 months, every other week through 12 to 16 months, and then monthly to 24 to 28 months postenrollment.The first 6 to 8 months included behavioral change targets to promote weight loss, including increasing PA and an individual calorie intake goal. PALs focused on teaching the families behavioral skills (eg, selfmonitoring, goal-setting, and problem-solving). In the next phase of the TLP, lifestyle maintenance was the focus of the intervention and the behavioral targets were ...

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the longitudinal change in health behavior profiles across treatment groups in the TODAY clinical trial

et al. 2020

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“…Adaptation of healthy lifestyle behavior may have a significant effect on the diabetes status of a patient. The implementation of healthy lifestyle behavior among adolescent patients means better mental health and good glycemic status ( 36 , 37 ).…”

Section: Methodsmentioning

confidence: 99%

Self-Care and Self-Management Among Adolescent T2DM Patients: A Review

et al. 2018

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Uncontrolled hyperglycaemia can lead to macro- and microvascular complications. Adolescents with T2DM develop similar complications as in adults, including cardiovascular disease, stroke, myocardial infarction, renal insufficiency, and chronic renal failure. Although regular medical follow-up is essential to avoid long-term complications, patients with diabetes mellitus need to perform holistic self-care activities such as opting for a healthy diet, physical activity, self-monitoring, and proper medication. To the best of our knowledge, only a limited number of studies have focused on self-care activities and self-management, including self-care practices, supportive networks, and self-care education programs in adolescent with T2DM. Some of the studies focused on the appreciation of self-care in adolescents with T2DM. This review aimed to analyse self-care and self-management among adolescents with T2DM, and discuss the impact of self-care and self-management on glycaemic control. The difficulties faced by adolescents in self-managing their disease are also highlighted. Such information is essential for healthcare providers in promoting self-care practices among adolescents with T2DM. A thorough search of the literature was performed using three databases: Medline, Google Scholar, and Scopus. The articles focused on self-care and self-management of adolescents patients with T2DM aged between 12 and 19 years old were included. Findings from this review reveal that healthy food adaptation, adequate physical activity, proper medication practices, and regular glucose monitoring are the most common self-care practices. Parental involvement and clinician encouragement also contribute toward the practice of self-care and self-management among the adolescents with T2DM. In conclusion, independent self-management regimens and supportive networks for appropriate administration are vital factors to enhance clinical outcomes of adolescents with T2DM.

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Type 2 Diabetes and Pre-Diabetes in Pediatric Obesity

Bensignor

2023

Managing Pediatric Obesity Using Advanced Therapies

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Determinants of Readiness for Adopting Healthy Lifestyle Behaviors Among Indigenous Adolescents with Type 2 Diabetes in Manitoba, Canada: A Cross‐Sectional Study

Abstract: The readiness for adopting healthy lifestyle behaviors is low among adolescents with T2D. Being ready to adopt healthy lifestyle behaviors is associated with better mental health and glycemic control.

Cited by 18 publications

References 50 publications

Evaluation of the longitudinal change in health behavior profiles across treatment groups in the TODAY clinical trial

Evaluation of the longitudinal change in health behavior profiles across treatment groups in the TODAY clinical trial

Self-Care and Self-Management Among Adolescent T2DM Patients: A Review

Type 2 Diabetes and Pre-Diabetes in Pediatric Obesity

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