Lessons Learned in Supporting Women With Prediabetes Through Maintaining Diet and Exercise Behavior Changes Beyond a Diabetes-Prevention Counseling Program

in Case Studies in Sport and Exercise Psychology

Click name to view affiliation

Corliss BeanUniversity of British Columbia

Search for other papers by Corliss Bean in
Current site
Google Scholar
PubMed
Close
*
,
Tineke DineenUniversity of British Columbia

Search for other papers by Tineke Dineen in
Current site
Google Scholar
PubMed
Close
*
, and
Mary JungUniversity of British Columbia

Search for other papers by Mary Jung in
Current site
Google Scholar
PubMed
Close
*
Restricted access

Interventions involving exercise and diet can reduce the progression of Type 2 diabetes, yet they are often short-lived. Progressing toward self-managed maintenance is also challenging. If supports are in place to help individuals with behavior changes beyond immediate programming, they are more likely to maintain these changes. This is particularly the case for women, who often struggle to maintain diet and exercise changes and can benefit from social support. Small Steps for Big Changes is a 3-week counseling program housed in a local YMCA that aims to help people make exercise and diet changes. To understand how to best support women in maintaining these changes beyond program delivery, a knowledge-sharing event was held for 14 women who completed the intervention. The women engaged in a focus group to share challenges they had experienced in making diet and exercise changes and recommendations for continued support. Data were analyzed using a thematic analysis, and three recommendation areas were identified: (a) establishing peer support networks, (b) creating platforms to communicate prediabetes-related information, and (c) providing ongoing trainer support. Several recommendations have been implemented to support these women, and other individuals, postprogram. This case provides insights and recommendations for integration of initiatives beyond delivery of a behavior-change program housed in a community organization.

The authors are with the Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada.

Jung (mary.jung@ubc.ca) is corresponding author.
  • Collapse
  • Expand
  • Ackermann, R.T, Finch, E.A., Caffrey, H.M., Lipscomb, E.R., Hays, L.M., & Saha, C. (2011). Long-term effects of a community-based lifestyle intervention to prevent Type 2 diabetes: The DEPLOY extension pilot study. Chronic Illness, 7, 279290. PubMed ID: 21840914 doi:10.1177/1742395311407532

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Aziz, Z., Absetz, P., Oldroyd, J., Pronk, N.P., & Oldenburg, B. (2015). A systematic review of real-world diabetes prevention programs: Learnings from the last 15 years. Implementation Science, 10, 172. PubMed ID: 26670418 doi:10.1186/s13012-015-0354-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bean, C., Dineen, T.E., & Jung, M.E. (2020). “It’s a life thing, not a few month thing”: Profiling patterns of the physical activity change process and associated strategies of women with prediabetes over 1 year [Manuscript submitted for publication].

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Bean, C., Dineen, T.E., Locke, S.R., Bouvier, B., & Jung, M.E. (2019). An evaluation of reach and effectiveness of a diabetes prevention lifestyle behaviour change program in the community [Manuscript submitted for publication].

    • Search Google Scholar
    • Export Citation
  • Bean, C., Forneris, T., & Halsall, T. (2014). Girls Just Wanna Have Fun: A process evaluation of a female youth-driven physical activity-based life skills program. Springerplus, 3, 401. doi:10.1186/2193-1801-3-401

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bean, C., Fortier, M., & Chima, K. (2019). Exploring challenges and strategies associated with the demands of competitive male youth hockey on mothers’ health. Leisure/Loisir, 43(1), 125150. doi:10.1080/14927713.2019.1583075

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bean, C., Hourston, L., Dineen, T., & Jung, M.E. (2019). You spoke, we listened (and acted): Continuing to support women with prediabetes in making behaviour changes post-intervention [Abstract]. Journal of Exercise, Movement, and Sport, 51(1), 181.

    • Search Google Scholar
    • Export Citation
  • Bean, C., Lewis, E., & Jung, M.E. (2018). Exploring women with prediabetes anticipated and identified barriers to making lifestyle changes. Abstract presented at the Qualitative Research in Sport and Exercise International Conference, Vancouver, BC, Canada.lsakdfj

    • Search Google Scholar
    • Export Citation
  • Beaulieu, R.J. (2013). Action research: Trends and variations. Canadian Journal of Action Research, 14, 2939. doi:10.33524/cjar.v14i3.99

    • Search Google Scholar
    • Export Citation
  • Bilandzic, A., & Rosella, L. (2017). The cost of diabetes in Canada over 10 years: Applying attributable health care costs to a diabetes incidence prediction model. Health Promotion and Chronic Disease Prevention in Canada, 37(2), 4953. PubMed ID: 28273040 doi:10.24095/hpcdp.37.2.03

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bourne, J.E., Little, J.P., Beauchamp, M R., Barry, J., Singer, J., & Jung, M.E. (2019). Brief exercise counseling and high-intensity interval training on physical activity adherence and cardiometabolic health in individuals at risk of Type 2 diabetes: Protocol for a randomized controlled trial. Journal of Medical Internet Research Protocols, 8(3), e11226. doi:10.2196/11226

    • Search Google Scholar
    • Export Citation
  • Braun, V., Clarke, V., & Weate, P. (2016). Using thematic analysis in sport and exercise research. In B. Smith & A.C. Sparkes (Eds.), Routledge handbook of qualitative research in sport and exercise (pp. 290309). New York, NY: Routledge.

    • Search Google Scholar
    • Export Citation
  • Casey, D., De Civita, M., & Dasgupta, K. (2010). Understanding physical activity facilitators and barriers during and following a supervised exercise programme in Type 2 diabetes: A qualitative study. Diabetes Medicine, 27, 7984. doi:10.1111/j.1464-5491.2009.02873.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chatterjee, S., Khunti, K., & Davies, M.J. (2017). Type 2 diabetes. Lancet, 389, 22392251. PubMed ID: 28190580 doi:10.1016/S0140-6736(17)30058-2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cranston, K. (2019). Sustainability of motivational interviewing skills in new Small Steps for Big Changes coaches [Unpublished master’s thesis]. Kelowna, BC, Canada: University of British Columbia.

    • Search Google Scholar
    • Export Citation
  • Creswell, J.W., & Clark, V.L.P. (2017). Designing and conducting mixed methods research. Thousand Oaks, CA: Sage.

  • Cutworth, N. (2013). The journey of a community engaged scholar: An autoethnography. Quest, 65, 1430. doi:10.1080/00336297.2012.727369.

  • Daley, C.M., James, A.S., Ulrey, E., Joseph, S., Talawyma, A., Choi, W.S., . . . Coe, M.K. (2010). Using focus groups in community-based participatory research: Challenges and resolutions. Qualitative Health Research, 20, 697706. doi:10.1177/1049732310361468

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Denzin, N.K., & Lincoln, Y.S. (Eds.). (2018). The Sage handbook of qualitative research (5th ed.). Thousand Oaks, CA: Sage.

  • Diabetes Canada. (2017). Diabetes statistics in Canada. Retrieved from http://www.diabetes.ca/how-you-can-help/advocate/why-federal-leadership-is-essential/diabetes-statistics-in-canada

    • Search Google Scholar
    • Export Citation
  • Diabetes Canada. (2018). Diabetes Canada 360 strategy. Retrieved from https://www.diabetes.ca/strategy

  • Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of Type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346, 393403. doi:10.1056/NEJMoa012512

    • Search Google Scholar
    • Export Citation
  • Embuldeniya, G., Veinot, P., Bell, E., Bell, M., Nyhof-Young, J., Sale, E.M., & Britten, N. (2013). The experience and impact of chronic disease peer support interventions: A qualitative synthesis. Patient Education and Counseling, 92, 312. PubMed ID: 23453850 doi:10.1016/j.pec.2013.02.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Giachello, A.L., Arrom, J.O., Davis, M., Sayad, J.V., Ramirez, D., Nandi, C., & Ramos, C. (2003). Reducing diabetes health disparities through community-based participatory action research: The Chicago Southeast Diabetes Community Action Coalition. Public Health Reports, 118, 309323. PubMed ID: 12815078 doi:10.1093/phr/118.4.309

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Goldberg, A.E., & Allen, K.R. (2015). Communicating qualitative research: Some practical guideposts for scholars. Journal of Marriage & Family, 77, 322. doi:10.1111/jomf.12153

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hernan, W.H., Brandle, M., Zhang, P., Williamson, D.F., Matulik, M.J., Ratner, R.E., . . . Diabetes Prevention Program Research Group. (2003). Costs associated with the primary prevention of Type 2 diabetes mellitus in the diabetes prevention program. Diabetes Care, 26, 3647. PubMed ID: 12502656. doi:10.2337/diacare.26.1.36.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • House, J.S. (1981). Work stress and social support. Reading, MA: Addison-Wesley.

  • Interior Health. (2017). Population/local health area & facility profiles. Retrieved from https://www.interiorhealth.ca/AboutUs/QuickFacts/PopulationLocalAreaProfiles/Pages/default.aspx

    • Search Google Scholar
    • Export Citation
  • International Diabetes Federation. (2018). About diabetes. Retrieved from https://www.idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html

    • Search Google Scholar
    • Export Citation
  • Jung, M.E., Bray, S.R., & Martin Ginis, K.A. (2008). Behavior change and the freshman 15: Tracking physical activity and dietary patterns in 1st-year university women. Journal of American College Health, 56(5), 523530. doi:10.3200/jach.56.5.523-530

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Larson, H.K., McFadden, K., McHugh, T.L.F., Berry, T.R., & Rodgers, W.M. (2018). When you don’t get what you want—and it’s really hard: Exploring motivational contributions to exercise dropout. Psychology of Sport & Exercise, 37, 5966. doi:10.1016/j.psychsport.2018.04.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lindström, J., Louheranta, A., Mannelin, M., Rastas, M., Salminen, V., Eriksson, J., . . . Tuomilehto, J. (2003). The Finnish Diabetes Prevention Study (DPS). Diabetes Care, 26, 32303236. doi:10.2337/diacare.26.12.3230

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Love, R., Adams, J., van Sluijs, E.M.F., Foster, C., & Humphreys, D. (2018). A cumulative meta-analysis of the effects of individual physical activity interventions targeting healthy adults. Obesity Review, 19, 11641172. doi:10.1111/obr.12690.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Martin Ginis, K.A., Jung, M.E., & Gauvin, L. (2003). To see or not to see: Effects of exercising in mirrored environments on sedentary women’s feeling states and self-efficacy. Health Psychology, 22(4), 354361. http://dx.doi.org/10.1037/0278-6133.22.4.354

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McDonald, S., O’Brien, N., White, M., & Sniehotta, F.F. (2015). Changes in physical activity during the retirement transition: A theory-based, qualitative interview study. International Behavioral Nutrition and Physical Activity, 12, 25. doi:10.1186/s12966-015-0186-4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mitchell, K., & Branigan, P. (2000). Using focus groups to evaluate health promotion interventions. Health Education, 100, 261268. doi:10.1108/09654280010354887

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Nakkeeran, N., & Zodpey, S.P. (2012). Qualitative research in applied situations: Strategies to ensure rigor and validity. Public Health Research Methods, 56, 411. doi:10.4103/0019-557X.96949

    • Search Google Scholar
    • Export Citation
  • Penn, L., Dombrowski, S.U., Sniehotta, F.F., & White, M. (2013). Participants’ perspectives on making and maintaining behavioural changes in a lifestyle intervention for Type 2 diabetes prevention: A qualitative study using the theory domain framework. BMJ Open, 3, e002949. PubMed ID: 23811173 doi:10.1136/bmjopen-2013-002949

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Penn, L., Moffatt, S.M., & White, M. (2008). Participants’ perspective on maintaining behaviour change: A qualitative study within the European Diabetes Prevention Study. BMC Public Health, 8, 235245. PubMed ID: 18616797 doi:10.1186/1471-2458-8-235

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Piette, D.J., Resnicow, K., Choi, H., & Heisler, M. (2013). A diabetes peer support intervention that improved glycemic control: Mediators and moderators of intervention effectiveness. Chronic Illness, 9, 258267. PubMed ID: 23585636 doi:10.1177/1742395313476522

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pronk, N.P., Remington, P.L., & Community Preventive Services Task Force. (2015). Combined diet and physical activity promotion programs for prevention of diabetes: Community preventive services task force recommendation statement. Annals of Internal Medicine, 163, 465468. PubMed ID: 26168073 doi:10.7326/M15-1029

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rockette-Wagner, B., Storti, K.L., Dabelea, D., Edelstein, S., Florez, H., . . . Diabetes Prevention Program Research Group. (2017). Activity and sedentary time 10 years after a successful lifestyle intervention: The Diabetes Prevention Program. American Journal of Preventive Medicine, 52, 292299. doi:10.1016/j.amepre.2016.10.007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rosella, L.C., Lebenbaum, M., Fitzpatrick, T., Zuk, A., & Booth, G.L. (2015). Prevalence of prediabetes and undiagnosed diabetes in Canada (2007–2011) according to fasting plasma glucose and HbA1c screening criteria. Diabetes Care, 38, 12991305. PubMed ID: 25852207 doi:10.2337/dc14-2474

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Samdal, G.B., Eide, G.E., Barth, T., Williams, G., & Meland, E. (2017). Effective behaviour change techniques for physical activity and healthy eating in overweight and obese adults: Systematic review and meta-regression analyses. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 42. PubMed ID: 28351367 doi:10.1186/s12966-017-0494-y

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Schinke, R.J., McGannon, K.R., & Smith, B. (2013). Expanding the sport and physical activity research landscape through community scholarship: Introduction. Qualitative Research in Sport, Exercise and Health, 5, 287290. doi:10.1080/2159676X.2013.847477

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Schinke, R.J., Smith, B., & McGannon, K.R. (2013). Pathways for community research in sport and physical activity: Criteria for consideration. Qualitative Research in Sport, Exercise and Health, 5, 460468. doi:10.1080/2159676X.2013.846274

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Small, S.A. (1995). Action-oriented research: Models and methods. Journal of Marriage and Family, 57(4), 941955. doi:10.2307/353414

  • Small, S.A., & Uttal, L. (2005). Action-oriented research: Strategies for engaged scholarship. Journal of Marriage and Family, 67, 936948. doi:10.1111/j.1741-3737.2005.00185.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sparkes, A.C., & Smith, B. (2009). Judging the quality of qualitative inquiry: Criteriology and relativism in action. Psychology of Sport and Exercise, 10, 491497. doi:10.1016/j.psychsport.2009.02.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sparkes, A.C., & Smith, B. (2014). Qualitative research methods in sport, exercise and health: From process to product. London, UK: Routledge.

    • Search Google Scholar
    • Export Citation
  • Statistics Canada. (2018). Retirement age by class of worker, annual. Retrieved from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1410006001

    • Search Google Scholar
    • Export Citation
  • Tava’e, N., & Nosa, V. (2012). The Green Prescription programme and the experiences of Pacific women in Auckland. Journal of Primary Health Care, 4, 313319. doi:10.1071/HC12313

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Taylor, S.E. (2011). Social support: A review. In H.S. Friedman (Ed.), The Oxford handbook of health psychology (pp. 189214). New York, NY: Oxford University Press.

    • Search Google Scholar
    • Export Citation
  • Tulloch, H., Sweet, S.N., Fortier, M., Capstick, G., Kenny, G.P., & Sigal, R.J. (2013). Exercise facilitators and barriers from adoption to maintenance in the diabetes aerobic and resistance exercise trial. Canadian Journal of Diabetes, 37(6), 367374. PubMed ID: 24321716 doi:10.1016/j.jcjd.2013.09.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • World Health Organization. (2018). Diabetes. Retrieved from https://www.who.int/news-room/fact-sheets/detail/diabetes

  • Wycherley, T.P., Mohr, P., Noakes, M., Clifton, P.M., & Brinkworth, G.D. (2012). Self-reported facilitators of, and impediments to maintenance of healthy lifestyle behaviours following a supervised research-based lifestyle intervention programme in patients with Type 2 diabetes. Diabetic Medicine, 29, 632639. PubMed ID: 21916973 doi:10.1111/j.1464-5491.2011.03451.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Young, L.E. (2013). Participatory action research: A new science for nursing? In C.T. Beck (Ed.), Routledge international handbook of qualitative nursing research (pp. 319330). New York, NY: Routledge.

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 1931 795 97
Full Text Views 80 7 0
PDF Downloads 60 9 0