Outcomes of a community-based lifestyle programme for adults with diabetes or pre-diabetes
Chris Higgs 1 2 , Margot Skinner 1 , Leigh Hale 1
+ Author Affiliations
- Author Affiliations
1 School of Physiotherapy, University of Otago, PO Box 56, Dunedin 9054, New Zealand
2 Correspondence to: Chris Higgs, MPhty, School of Physiotherapy, University of Otago, PO Box 56, Dunedin 9054, New Zealand. Email: chris.higgs@otago.ac.nz
Journal of Primary Health Care 8(2) 130-139 https://doi.org/10.1071/HC15038
Published: 30 June 2016
Journal Compilation © Royal New Zealand College of General Practitioners 2016.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Diabetes, a long-term condition increasing in prevalence, requires ongoing healthcare management. Exercise alongside lifestyle education and support is effective for diabetes management.
AIM: To investigate clinical outcomes and acceptability of a community-based lifestyle programme for adults with diabetes/prediabetes at programme completion and 3-month follow-up.
METHODS: The 12-week community programme included twice-weekly sessions of self-management education and exercise, supervised by a physiotherapist, physiotherapy students and a nurse. Clinical outcomes assessed were cardiorespiratory fitness, waist circumference, exercise behaviour and self-efficacy. A standardised evaluation form was used to assess programme acceptability.
RESULTS: Clinically significant improvements were found from baseline (n = 36) to programme completion (n = 25) and 3-months follow-up (n = 20) for the six minute walk test (87 m (95%CI 65–109; p ≤ 0.01), 60 m (95%CI 21–100; p ≤ 0.01)), waist circumference (−3 cm (95%CI −6 to –1), −3 cm (95%CI –6 to 1)), exercise behaviour (aerobic exercise 53 min/week (95%CI 26 to 81; p ≤ 0.01), 71 min/week (95%CI 25 to 118; p ≤ 0.01)) and self-efficacy (0.7 (95%CI −0.2 to 1.6), 0.8 (95%CI 0.04 to 1.5)). Good programme acceptability was demonstrated by themes suggesting a culturally supportive, motivating, friendly, informative atmosphere within the programme. The attrition rate was 30% but there were no adverse medical events related to the programme.
DISCUSSION: The programme was safe and culturally acceptable and outcomes demonstrated clinical benefit to participants. The attrition rate was largely due to medical reasons unrelated to the programme. This model of a community-based lifestyle programme has the potential to be reproduced in other regions and in adults with similar long-term conditions.
KEYWORDS: Diabetes Mellitus Type II; Prediabetic state; Co-morbidity; Exercise; Self-management
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