Increase in Daily Steps After an Exercise Specialist Led Lifestyle Intervention for Adults With Type 2 Diabetes in Primary Care: A Controlled Implementation Trial

Abstract

A 6-month lifestyle program delivered in primary care by an exercise specialist can be effective for increasing daily walking among adults with recently diagnosed type 2 diabetes. This short-term increase in daily steps requires longer follow-up to estimate the potential impact on health outcomes.

Contextualizing the Proven Effectiveness of a Lifestyle Intervention for Type 2 Diabetes in Primary Care: A Qualitative Assessment Based on the RE-AIM Framework

“…Given the large volume of data collected for our comprehensive evaluation (19), our findings related to the other RE-AIM dimensions are reported elsewhere, in previous (25) and accompanying papers (28,29). Here, we describe the implementation fidelity of the HEALD intervention at the organization assessment level, including the delivery of intervention components and provider satisfaction, to determine whether its execution influenced its effectiveness.…”

“…It is important to note that all respondents commented on the implementation and/or perceived effectiveness of HEALD prior to completion of the larger study (25). As such, the respondents did not know that the intervention was effective in increasing the patients' physical activity when they provided their feedback.…”

“…Effectiveness was determined by using an on/off time series design (26) with 2 groups: the on group, who participated in the HEALD intervention; and the off group, the active-control group, who received pedometers and generic print-based healthful eating and active living resources (27). The primary outcome was self-reported number of steps according to a pedometer; after 6 months, the HEALD participants reported an increase in average daily steps compared to participants in the active-control group (25).…”

Challenges in Identifying Patients with Type 2 Diabetes for Quality-Improvement Interventions in Primary Care Settings and the Importance of Valid Disease Registries

“…the R [reach] of the RE-AIM framework [13]). Given the volume of data collected for our comprehensive evaluation (8), we have reported our findings related to the other RE-AIM dimensions elsewhere in previous (11,12) and accompanying papers (14e16). We expanded the original definition of reach beyond the absolute number, proportion and representativeness of individuals (i.e.…”

“…The interventions focused on lifestyle counselling (9) and mental health improvement (10), and both were shown to be effective in Alberta's PCN setting (11,12). We adopted the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework (13) to assess comprehensively both the individual and the organizational factors associated with operationalizing the ABCD interventions in this primary care setting so as to inform policy decision making (8).…”