Feasibility and effectiveness of a pilot health promotion program for adults with type 2 diabetes: lessons learned.
The purpose of this pilot study was to assess the feasibility and effectiveness of an intense health promotion program in older adults with diabetes. The program combined individually prescribed and supervised exercise with nutrition and education programs on glycemic control and aerobic fitness.



Various recruitment and retention strategies were analyzed for effectiveness. Out of 28 potential subjects assessed for eligibility, 6 subjects with type 2 diabetes (2 male and 4 female; all white; age, 60.2 +/- 4.7 years) participated in the 10-week intervention. Aerobic and resistance exercise was performed on alternate days (3-4 days per week), with individualized nutrition counseling and diabetes health education sessions once weekly. The primary outcome measures were aerobic fitness and glycemic control (A1C), and secondary outcome measures included body mass index (BMI), self-efficacy, and symptoms of neuropathy. Changes in outcomes were assessed using descriptive statistics and paired t test analysis (alpha = .05).



Following the intervention, subjects had improvements that approached significance in A1C and pain, with significant improvements in self-efficacy.



A systematic approach to analysis of feasibility revealed issues with recruitment and retention that would need to be addressed for future studies or clinical implementation of this program. However, for the subset of subjects who did complete the intervention, adherence was excellent, and satisfaction with the program was confirmed by exit interview comments. Following participation in this pilot health promotion program, subjects had meaningful improvements in glycemic control, pain, and self-efficacy.
Kluding
Patricia M
PM
The Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas (Dr Kluding, Ms Singh, Mr Rucker, Dr Bracciano, Dr Curry)
Singh
Rupali
R
The Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas (Dr Kluding, Ms Singh, Mr Rucker, Dr Bracciano, Dr Curry)
Goetz
Jeanine
J
The General Clinical Research Center and Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas (Dr Goetz)
Rucker
Jason
J
The Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas (Dr Kluding, Ms Singh, Mr Rucker, Dr Bracciano, Dr Curry)
Bracciano
Sarah
S
The Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas (Dr Kluding, Ms Singh, Mr Rucker, Dr Bracciano, Dr Curry)
Curry
Natasha
N
The Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas (Dr Kluding, Ms Singh, Mr Rucker, Dr Bracciano, Dr Curry)
D000328:Adult; D000368:Aged; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology / Q000534:rehabilitation*; D005240:Feasibility Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006293:Health Promotion; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010809:Physical Fitness; D010865:Pilot Projects; D020377:Self Efficacy; D016896:Treatment Outcome
D006442:Glycated Hemoglobin