title: Increasing diabetes educators' confidence in physical activity and exercise counselling: the effectiveness of the "physical activity and exercise toolkit" training intervention.
abstract: OBJECTIVE
  The objective of this action research was to examine the effectiveness of a comprehensive intervention (the toolkit) in improving diabetes educators' (DEs') perceptions of their abilities and their patients' abilities related to physical activity as part of regular diabetes self-management.
  
  
  METHODS
  Two separate studies were conducted. Participants completed measures assessing confidence, attitudes and perceived difficulty. In study 1, a quasi-experimental design was used to examine the impact of the training intervention at 6 months. Cross-sectional sampling at baseline and 12 months then was used to assess the longer-term impact of the intervention. In study 2, a pre-post design was used to test the impact of the intervention at 12-months in a separate sample.
  
  
  RESULTS
  The primary finding was a consistent increase in DEs' confidence in their ability to provide physical activity and exercise counselling with increases of up to 20% after the training intervention. Furthermore, DEs reported greater knowledge about physical activity (p<0.03) yet perceived physical activity counselling to be more difficult after receiving the training (p<0.05). In study 2, the DEs reported increases in perceived patient knowledge and confidence in their patients (p<0.03) after the intervention. Secondary analyses showed that frequently referring to the toolkit was associated with higher counselling efficacy and lower perceived difficulty (p<0.03).
  
  
  CONCLUSIONS
  These findings suggest that the toolkit is an effective resource to improve DEs' confidence in the area of physical activity counselling. As a result of this work, the toolkit has been adopted as standard diabetes care across Nova Scotia and as a foundational resource for DEs across Canada.
authors: School of Recreation Management and Kinesiology, Acadia University, Wolfville, Nova Scotia, Canada; Centre of Lifestyle Studies, Acadia University, Wolfville, Nova Scotia, Canada. Electronic address: chris.shields@acadiau.ca.
authors: Christopher A
authors: CA
authors: Shields
authors: Jonathon R
authors: JR
authors: Fowles
authors: Peggy
authors: P
authors: Dunbar
authors: Brittany
authors: B
authors: Barron
authors: Stephanie
authors: S
authors: McQuaid
authors: Carrie J
authors: CJ
authors: Dillman
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000628:therapy*; D037001:Directive Counseling; D015444:Exercise; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: activité physique; counseling; counselling; diabetes; diabète; education; efficacité; efficacy; enseignement; exercice; exercise; patients; physical activity