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Behaviour change techniques targeting both diet and physical activity in type 2 diabetes: A systematic review and meta-analysis.
- Source :
- International Journal of Behavioral Nutrition & Physical Activity; 2/8/2017, Vol. 14, p1-17, 17p, 1 Diagram, 5 Charts
- Publication Year :
- 2017
-
Abstract
- Background: Changing diet and physical activity behaviour is one of the cornerstones of type 2 diabetes treatment, but changing behaviour is challenging. The objective of this study was to identify behaviour change techniques (BCTs) and intervention features of dietary and physical activity interventions for patients with type 2 diabetes that are associated with changes in HbA<subscript>1c</subscript> and body weight. Methods: We performed a systematic review of papers published between 1975-2015 describing randomised controlled trials (RCTs) that focused exclusively on both diet and physical activity. The constituent BCTs, intervention features and methodological rigour of these interventions were evaluated. Changes in HbA<subscript>1c</subscript> and body weight were meta-analysed and examined in relation to use of BCTs. Results: Thirteen RCTs were identified. Meta-analyses revealed reductions in HbA<subscript>1c</subscript> at 3, 6, 12 and 24 months of -1. 11 % (12 mmol/mol), -0.67 % (7 mmol/mol), -0.28 % (3 mmol/mol) and -0.26 % (2 mmol/mol) with an overall reduction of -0.53 % (6 mmol/mol [95 % CI -0.74 to -0.32, < 0.00001]) in intervention groups compared to control P groups. Meta-analyses also showed a reduction in body weight of -2.7 kg, -3.64 kg, -3.77 kg and -3.18 kg at 3, 6, 12 and 24 months, overall reduction was -3.73 kg (95 % CI -6.09 to -1.37 kg, = 0.002). P Four of 46 BCTs identified were associated with >0.3 % reduction in HbA<subscript>1c</subscript>: 'instruction on how to perform a behaviour', 'behavioural practice/rehearsal', 'demonstration of the behaviour' and 'action planning', as were intervention features 'supervised physical activity', 'group sessions', 'contact with an exercise physiologist', 'contact with an exercise physiologist and a dietitian', 'baseline HbA<subscript>1c</subscript> >8 %' and interventions of greater frequency and intensity. Conclusions: Diet and physical activity interventions achieved clinically significant reductions in HbA<subscript>1c</subscript> at three and six months, but not at 12 and 24 months. Specific BCTs and intervention features identified may inform more effective structured lifestyle intervention treatment strategies for type 2 diabetes. [ABSTRACT FROM AUTHOR]
- Subjects :
- TYPE 2 diabetes treatment
BEHAVIOR modification
BODY weight
CINAHL database
COMBINED modality therapy
CONFIDENCE intervals
GLYCOSYLATED hemoglobin
INFORMATION storage & retrieval systems
MEDICAL databases
MEDICAL information storage & retrieval systems
PSYCHOLOGY information storage & retrieval systems
MEDLINE
META-analysis
ONLINE information services
PROBABILITY theory
REDUCING diets
RESEARCH funding
STATISTICS
T-test (Statistics)
TERMS & phrases
TIME
WEIGHT loss
SYSTEMATIC reviews
EVIDENCE-based medicine
PROFESSIONAL practice
STATISTICAL significance
EFFECT sizes (Statistics)
RANDOMIZED controlled trials
INTER-observer reliability
RESEARCH bias
PHYSICAL activity
DATA analysis software
MEDICAL coding
DESCRIPTIVE statistics
EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 14795868
- Volume :
- 14
- Database :
- Complementary Index
- Journal :
- International Journal of Behavioral Nutrition & Physical Activity
- Publication Type :
- Academic Journal
- Accession number :
- 121218600
- Full Text :
- https://doi.org/10.1186/s12966-016-0436-0