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Development of a Theory-Based Daily Activity Intervention for Individuals With Type 2 Diabetes

Prevention Research Center, School of Public Health, University of South Carolina, Columbia, SC 29208 ctudor{at}sph.sc.edu

Anita M. Myers, PhD

Department of Health Studies and Gerontology, the University of Waterloo, Waterloo, Ontario, Canada; Centre for Activity and Ageing, the University of Western Ontario, London, Ontario, Canada; St. Joseph's Health Centre, London, Ontario, Canada

N. Wilson Rodger, MD, FRCPC

Lawson Diabetes Centre, the University of Western Ontario, London, Ontario, Canada; St. Joseph's Health Centre, London, Ontario, Canada

PURPOSE

This article describes a theory-driven approach to developing a physical activity intervention for sedentary individuals with type 2 diabetes.

METHODS

Development of the intervention was based on 6 essential elements of program theory: problem definition, critical inputs, mediating processes, expected outcomes, extraneous factors, and implementation issues. Each element was formulated based on available literature and in collaboration with both intended service deliverers (diabetes educators) and recipients (sedentary persons with type 2 diabetes).

RESULTS

Diabetes education requires a simple physical activity intervention template that is feasible, acceptable, and effective in a variety of settings. Successful programs are individualized, specific, flexible, and based on walking. Pedometers have potential as self-monitoring and feedback tools. The primary expected outcome is an increase in physical activity, specifically walking. Behavior modification and social support are critical to adoption and adherence.

CONCLUSIONS

Theory-driven interventions specify what works for whom and under what conditions of delivery. The underlying theoryguides the evaluation, refinement, and clinical replication of an intervention. Recruitment, delivery, and follow-up are realworld implementation issues.

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