Effectiveness of the First Step Program Delivered by Professionals Versus Peers

in Journal of Physical Activity and Health
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Background:

To compare the effectiveness of a theory-based lifestyle physical activity (PA) program delivered to individuals with type 2 diabetes in diabetes education centers by professionals and peers.

Methods:

Changes over 16 weeks in PA (steps/day) and related variables (weight, waist girth, resting heart rate, systolic and diastolic blood pressures) were compared (RMANOVA) for two groups: 157 participants led by 13 different professionals versus 63 participants led by 5 peer leaders.

Results:

Overall, the 81 male and 139 female participants (age = 55.7 ± 7.3 years, BMI = 35.2 ± 6.6) showed an incremental change of 4,059 ± 3,563 steps/day, which translates into an extra 37 minutes of daily walking (P < .001). Statistically significant improvements were also seen in weight, waist girth, and blood pressure (all P < .001) and resting heart rate (P < .05). There were no significant differences in outcomes between professional and peer-led groups.

Conclusions:

A theory-based behavior modification program featuring simple feedback and monitoring tools, and with a proven element of flexibility in delivery, can be effective under real-world conditions while addressing inevitable concerns about resource allocation. Program delivery by peer leaders, in particular, could address a potential obstacle to dissemination by helping to alleviate existing high caseload demands on diabetes educators.

Tudor-Locke is with the Walking Behavior Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA, and the Dept of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada. Lauzon and Myers are with Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada. Bell and McCar-gar are with the Dept of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada. Chan is with the Dept of Biomedical Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada. Speechley is with the Dept of Epidemiology & Bio-statistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada. Rodger is with the Dept of Medicine, Schulich School of Medicine & Dentistry, and Canadian Centre for Activity and Aging, University of Western Ontario, London, Ontario, Canada.