Effectiveness of the First step Program delivered by professionals versus peers.
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.
Walking Behavior Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA.
Catrine
C
Tudor-Locke
Nicola
N
Lauzon
Anita M
AM
Myers
Rhonda C
RC
Bell
Catherine B
CB
Chan
Linda
L
McCargar
Mark
M
Speechley
N Wilson
NW
Rodger
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001837:Body Weights and Measures; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D015444:Exercise; D005260:Female; D006282:Health Personnel; D006293:Health Promotion / Q000458:organization & administration*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010379:Peer Group