title: Peer telephone counseling for adults with type 2 diabetes mellitus: a case-study approach to inform the design, development, and evaluation of programs targeting physical activity.
abstract: The purpose of this case study was to determine the feasibility of peer-led telephone counseling for people with type 2 diabetes mellitus related to physical activity (PA) and to establish preliminary efficacy of peer-led telephone counseling for eliciting recommended changes in PA-related cognitions and behaviors for adults with type 2 diabetes mellitus.
  
  
  
  A total of 8 adults (5 males and 3 females, aged 59.5 (6.5) years) with type 2 diabetes mellitus completed quantitative self-report measures of aerobic-based PA, resistance training (RT), along with metrics from social cognitive theory (SCT) before and after a 12-week intervention. Qualitative data from weekly peer-led telephone sessions were collected by a peer counselor and subsequently organized into themes and analyzed using a mixed-methods, collective case-study approach.
  
  
  
  PA behaviors remained relatively constant over the 12-week intervention. Self-efficacy for RT improved (z = -2.03; P = .04). From the peer counselor's perspective, identifiable inhibitors to PA, which included low self-efficacy and disease condition limitations, were successfully translated into enablers/motivators. Perceived health benefits were frequently reported by the peer counselor as motivators for the participants over the study period. Participants believed peer counseling by telephone influenced their decision to continue to participate in PA.
  
  
  
  Theory-based, peer-led telephone counseling shows some promise for increasing receptiveness to PA, but had little effect on improving behavior for most participants. Further studies will be necessary to determine the effectiveness and the sustainability of this approach.
authors.affiliation: The School of Education, the University of Newcastle, Callaghan, NSW, Australia (Dr Plotnikoff)|Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, Alberta, Canada (Dr Plotnikoff, Ms Luchak, Ms Pollock, Ms Leahy, Ms Liebreich)|The Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada (Dr Plotnikoff, Dr Holt, Dr Boulé)|The Alberta Centre for Active Living, Edmonton, Alberta, Canada (Dr Plotnikoff)
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Plotnikoff
authors.affiliation: Center for Nursing & Health Studies, Athabasca University, Athabasca, Alberta, Canada (Dr Johnson)
authors.forename: Steven T
authors.initials: ST
authors.lastname: Johnson
authors.affiliation: Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, Alberta, Canada (Dr Plotnikoff, Ms Luchak, Ms Pollock, Ms Leahy, Ms Liebreich)
authors.forename: Mila
authors.initials: M
authors.lastname: Luchak
authors.affiliation: Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, Alberta, Canada (Dr Plotnikoff, Ms Luchak, Ms Pollock, Ms Leahy, Ms Liebreich)
authors.forename: Cathy
authors.initials: C
authors.lastname: Pollock
authors.affiliation: The Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada (Dr Plotnikoff, Dr Holt, Dr Boulé)
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Holt
authors.affiliation: Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, Alberta, Canada (Dr Plotnikoff, Ms Luchak, Ms Pollock, Ms Leahy, Ms Liebreich)
authors.forename: Annabel
authors.initials: A
authors.lastname: Leahy
authors.affiliation: Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, Alberta, Canada (Dr Plotnikoff, Ms Luchak, Ms Pollock, Ms Leahy, Ms Liebreich)
authors.forename: Tanis
authors.initials: T
authors.lastname: Liebreich
authors.affiliation: The Department of Medicine, Cardiac Sciences and Community Health Sciences, Faculties of Medicine andKinesiology, University of Calgary, Calgary, Canada (Dr Sigal)
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Sigal
authors.affiliation: The Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada (Dr Plotnikoff, Dr Holt, Dr Boulé)
authors.forename: Normand G
authors.initials: NG
authors.lastname: Boulé
mesh_terms: D000328:Adult; D000368:Aged; D003071:Cognition; D003376:Counseling / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation; D015444:Exercise; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010379:Peer Group; D055070:Resistance Training / Q000379:methods*; D013689:Telephone