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.
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.
Plotnikoff
Ronald C
RC
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)
Johnson
Steven T
ST
Center for Nursing & Health Studies, Athabasca University, Athabasca, Alberta, Canada (Dr Johnson)
Luchak
Mila
M
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)
Pollock
Cathy
C
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)
Holt
Nicholas L
NL
The Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada (Dr Plotnikoff, Dr Holt, Dr Boulé)
Leahy
Annabel
A
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)
Liebreich
Tanis
T
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)
Sigal
Ronald J
RJ
The Department of Medicine, Cardiac Sciences and Community Health Sciences, Faculties of Medicine andKinesiology, University of Calgary, Calgary, Canada (Dr Sigal)
Boulé
Normand G
NG
The Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada (Dr Plotnikoff, Dr Holt, Dr Boulé)
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