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Knowledge-Attitude-Practice-Based Outdoor Exercise Education for Patients With Type 2 Diabetes: A Randomized
Liwen Tu1, Qiang Liu2, Yun Shen3
1Department of Nursing, Shanghai Geriatric Medical Center, Shanghai, China.
Journal of Diabetes Research
|June 29, 2026
Summary
A structured Knowledge-Attitude-Practice (KAP)-based exercise program did not improve glycemic control or weight in Type 2 diabetes patients compared to standard guidance. Both approaches led to meaningful health improvements.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Exercise Science
Background:
- Type 2 diabetes management benefits from regular exercise, yet adherence is challenging.
- Knowledge-Attitude-Practice (KAP)-based education offers a potential strategy to enhance exercise adherence.
- This study evaluates a KAP-based outdoor exercise program versus traditional guidance for Type 2 diabetes patients.
Purpose of the Study:
- To assess if a KAP-based outdoor exercise education program improves glycemic and weight control over 6 months in Type 2 diabetes adults.
- To compare the efficacy of a structured KAP intervention against traditional exercise advice.
Main Methods:
- A 6-month, single-center, randomized controlled trial involving 220 adults with Type 2 diabetes.
- Participants were randomized to a KAP-based exercise education intervention or traditional exercise guidance.
- Primary outcomes (HbA1c, body weight) were assessed at baseline and 6 months; intention-to-treat analysis was used.
Main Results:
- Both groups showed significant HbA1c improvements and modest weight loss; no significant between-group differences were observed for these primary outcomes.
- The KAP group demonstrated significantly higher exercise adherence, with 80.4% meeting ≥150 min/week versus 57.8% in the control group.
- Average weekly exercise duration was higher in the KAP group (178.5 min) compared to the control group (154.8 min).
Conclusions:
- A KAP-based outdoor exercise program did not significantly improve glycemic control or body weight compared to traditional guidance in Type 2 diabetes patients.
- Both interventions resulted in clinically meaningful improvements in HbA1c and other health metrics over the 6-month study period.
- Enhanced exercise adherence was noted in the KAP group, suggesting potential benefits beyond primary outcome measures.
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