Preliminary outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type 2 diabetes.

The First Step Program uses simple and inexpensive pedometers to incrementally increase walking behaviors in sedentary individuals with type 2 diabetes. The pilot sample consisted of nine individuals (six women, three men; group mean age 53+/-6; group mean body mass index=32.9+/-3.4kg/m(2)). A timed self-paced walk while wearing the pedometer allowed for the conversion of changes in pedometer steps per day to time in minutes per day. There was an immediate and dramatic increase in walking behavior (an average of 34.3min of walking a day) that was sustained even 2 months post-intervention and after withdrawal of contact (an average of 22.6min of walking a day). Improvements in other outcomes (systolic blood pressure and waist girth) support a valid change in behavior. Although preliminary, these results warrant further investigation of such approaches.

[1]  C. Caspersen,et al.  Introduction to a Collection of Physical Activity Questionnaires , 1997 .

[2]  B. J. Winer.  Statistical Principles in Experimental Design , 1992 .

[3]  C. Tudor-Locke,et al.  Revisiting the role of physical activity and exercise in the treatment of type 2 diabetes. , 2000, Canadian journal of applied physiology = Revue canadienne de physiologie appliquee.

[4]  D. Clark,et al.  Correlates of physical activity in a sample of older adults with type 2 diabetes. , 1999, Diabetes care.

[5]  Lewis E. Kazis,et al.  Effect Sizes for Interpreting Changes in Health Status , 1989, Medical care.

[6]  D. Maclean,et al.  Epidemiology of diabetes mellitus in Canada. , 1995, Clinical and investigative medicine. Medecine clinique et experimentale.

[7]  Mark A Pereira,et al.  A collection of Physical Activity Questionnaires for health-related research. , 1997, Medicine and science in sports and exercise.

[8]  P. Deurenberg,et al.  Waist-hip ratio is a poor predictor of changes in visceral fat. , 1993, The American journal of clinical nutrition.

[9]  D R Bassett,et al.  Validity and Reliability issues in Objective Monitoring of Physical Activity , 2015 .

[10]  E. Ford,et al.  Leisure-Time Physical Activity Patterns in the U.S. Diabetic Population: Findings from the 1990 National Health Interview Survey—Health Promotion and Disease Prevention Supplement , 1995, Diabetes Care.

[11]  Anita M. Myers.  Program Evaluation for Exercise Leaders , 1999 .

[12]  L. Epstein,et al.  Exercise in a behavioural weight control programme for obese patients with Type 2 (non-insulin-dependent) diabetes , 1988, Diabetologia.

[13]  M Hillsdon,et al.  A systematic review of physical activity promotion strategies. , 1996, British journal of sports medicine.

[14]  Ready Ae,et al.  Survey of exercise and dietary knowledge and behaviour in persons with type II diabetes. , 1991 .

[15]  H. Nagaraja,et al.  Comparisons of four methods of estimating physical activity in adult women. , 2000, Medicine and science in sports and exercise.

[16]  Steven Blair,et al.  Low Cardiorespiratory Fitness and Physical Inactivity as Predictors of Mortality in Men with Type 2 Diabetes , 2000, Annals of Internal Medicine.

[17]  A Tremblay,et al.  Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. , 1994, The American journal of cardiology.

[18]  R. Wing,et al.  The effect of weight loss on change in waist-to-hip ratio in patients with type II diabetes. , 1992, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[19]  A. Bigard,et al.  Mobilization of Visceral Adipose Tissue Related to the Improvement in Insulin Sensitivity in Response to Physical Training in NIDDM: Effects of branched-chain amino acid supplements , 1997, Diabetes Care.

[20]  C. Tudor-Locke,et al.  A Preliminary Study to Determine Instrument Responsiveness to Change with a Walking Program: Physical Activity Logs versus Pedometers , 2001, Research quarterly for exercise and sport.

[21]  R. Lehmann,et al.  Loss of abdominal fat and improvement of the cardiovascular risk profile by regular moderate exercise training in patients with NIDDM , 1995, Diabetologia.

[22]  Yuzo Sato,et al.  Daily Walking Combined With Diet Therapy Is a Useful Means for Obese NIDDM Patients Not Only to Reduce Body Weight But Also to Improve Insulin Sensitivity , 1995, Diabetes Care.

[23]  L. Epstein,et al.  Providing sedentary adults with choices for meeting their walking goals. , 1999, Preventive medicine.

[24]  C. Tudor-Locke,et al.  Challenges and Opportunities for Measuring Physical Activity in Sedentary Adults , 2001, Sports medicine.

[25]  Barbara E. Ainsworth,et al.  Accuracy of five electronic pedometers for measuring distance walked. , 1996, Medicine and science in sports and exercise.

[26]  R. Klein,et al.  The association of glycemia and cause-specific mortality in a diabetic population. , 1994, Archives of internal medicine.

[27]  B E Ainsworth,et al.  Validity of four motion sensors in measuring moderate intensity physical activity. , 2000, Medicine and science in sports and exercise.

[28]  H. Lithell,et al.  Physical training as treatment for Type 2 (non-insulin-dependent) diabetes in elderly men. A feasibility study over 2 years , 1987, Diabetologia.

[29]  I. Raz,et al.  Moderate exercise improves glucose metabolism in uncontrolled elderly patients with non-insulin-dependent diabetes mellitus. , 1994, Israel journal of medical sciences.

[30]  K. Walker,et al.  Effects of regular walking on cardiovascular risk factors and body composition in normoglycemic women and women with type 2 diabetes. , 1999, Diabetes care.

[31]  Anita M. Myers,et al.  Methodological Considerations for Researchers and Practitioners Using Pedometers to Measure Physical (Ambulatory) Activity , 2001, Research quarterly for exercise and sport.

[32]  P S Freedson,et al.  Objective Monitoring of Physical Activity Using Motion Sensors and Heart Rate , 2000, Research quarterly for exercise and sport.

[33]  N. Ruderman,et al.  Ten-Year Experience with an Exercise-Based Outpatient Life-Style Modification Program in the Treatment of Diabetes Mellitus , 1992, Diabetes Care.

[34]  R. Holman,et al.  Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. , 1998 .

[35]  C. Tudor-Locke,et al.  Development of a Theory-Based Daily Activity Intervention for Individuals With Type 2 Diabetes , 2001, The Diabetes educator.