title: DiAlert: a prevention program for overweight first degree relatives of type 2 diabetes patients: results of a pilot study to test feasibility and acceptability.
abstract: BACKGROUND
  Prevalence of type 2 diabetes mellitus is increasing due to lifestyle changes, particularly affecting those genetically at risk. We developed DiAlert as a targeted group-based intervention aimed to promote intrinsic motivation and action planning for lifestyle changes and weight loss in first degree relatives of patients with type 2 diabetes mellitus.The main objective of the pilot of the DiAlert intervention was to assess fidelity, feasibility and acceptability prior to starting the randomized controlled trial.
  
  
  METHODS
  Individuals with a family history of type 2 diabetes mellitus were self-identified and screened for eligibility. DiAlert consists of two group sessions. Feasibility, fidelity, acceptability and self-reported perceptions and behavioral determinants were evaluated in a pre-post study using questionnaires and observations. Determinants of behavior change were analyzed using paired-samples t tests and Wilcoxon signed rank tests.
  
  
  RESULTS
  DiAlert was delivered to two groups of first degree relatives of patients with type 2 diabetes mellitus (N = 9 and N = 12). Feasibility and fidelity were confirmed. Overall, the DiAlert group sessions were positively evaluated (8.0 on a scale of 1 to 10) by participants. The intervention did not impact perceived susceptibility or worry about personal diabetes risk. Action planning with regard to changing diet and physical activity increased.
  
  
  CONCLUSIONS
  DiAlert proved feasible and was well-accepted by participants. Positive trends in action planning indicate increased likelihood of actual behavior change following DiAlert. Testing the effectiveness in a randomized controlled trial is imperative.
  
  
  BACKGROUND
  Netherlands National Trial Register (NTR): NTR2036.
authors.affiliation: Department of Medical Psychology, The EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. w.heideman@vumc.nl
authors.forename: Wieke H
authors.initials: WH
authors.lastname: Heideman
authors.forename: Maartje
authors.initials: M
authors.lastname: de Wit
authors.forename: Barend J C
authors.initials: BJ
authors.lastname: Middelkoop
authors.forename: Vera
authors.initials: V
authors.lastname: Nierkens
authors.forename: Karien
authors.initials: K
authors.lastname: Stronks
authors.forename: Arnoud P
authors.initials: AP
authors.lastname: Verhoeff
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Snoek
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D003924:Diabetes Mellitus, Type 2 / Q000235:genetics / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009426:Netherlands; D050177:Overweight / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D010375:Pedigree; D010865:Pilot Projects; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012307:Risk Factors; D040242:Risk Reduction Behavior; D057566:Self Report; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss