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Walking Away from Type 2 diabetes: a cluster randomized controlled trial.

T Yates1,2, C L Edwardson1,2, J Henson1,2

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The Walking Away from Type 2 Diabetes intervention modestly increased walking activity in primary care participants at high risk for Type 2 diabetes. However, these activity gains were not sustained long-term.

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Area of Science:

  • Public Health
  • Preventive Medicine
  • Behavioral Science

Background:

  • Type 2 diabetes mellitus (T2DM) poses a significant public health challenge.
  • Primary care settings are ideal for delivering interventions to individuals at high risk for T2DM.
  • Behavioral interventions can promote lifestyle changes, such as increased physical activity.

Purpose of the Study:

  • To evaluate the effectiveness of the "Walking Away from Type 2 Diabetes" program in increasing and sustaining walking activity.
  • To assess the intervention's impact when delivered within a primary care setting.
  • To determine the long-term maintenance of increased physical activity.

Main Methods:

  • A cluster randomized controlled trial was conducted in 10 UK general practices.
  • 808 individuals at high risk for T2DM were recruited and randomized.
  • The intervention group received a 3-hour group-based program with pedometer use and annual refreshers; the control group received usual care. Ambulatory activity was measured by accelerometer at 12, 24, and 36 months.

Main Results:

  • After 12 months, the intervention group showed a statistically significant increase in daily steps (411 steps/day) and self-reported vigorous physical activity.
  • These increases in ambulatory activity were not sustained at the 36-month follow-up.
  • No significant differences were found between groups for cardiometabolic health markers.

Conclusions:

  • The "Walking Away from Type 2 Diabetes" program, delivered in primary care, can achieve short-term increases in physical activity for high-risk individuals.
  • The intervention's benefits on walking activity were not maintained over 36 months.
  • Low-resource, group-based interventions show potential but require strategies for long-term adherence.