title: Implementation of resources to support patient physical activity through diabetes centres in Nova Scotia: the effectiveness of enhanced support for exercise participation.
abstract: OBJECTIVE
  The purpose of this study was to determine the effectiveness of enhancing support for physical activity counselling and exercise participation at diabetes centres in Nova Scotia on physical activity and exercise behaviours and clinical outcomes in patients with type 2 diabetes mellitus.
  
  
  METHODS
  In all, 180 patients at 8 diabetes centres participated in this observational study. A range of enhanced supports for exercise were offered at these centres. A kinesiologist was added to the diabetes care team to primarily provide extra physical activity counselling and exercise classes. Patient physical activity and exercise levels, efficacy perceptions and mean glycated hemoglobin (A1C) were evaluated at baseline and 6 months. We compared changes in these variables for patients who participated in the enhanced supports versus patients who did not.
  
  
  RESULTS
  Participants who attended exercise classes (n=46), increased moderate physical activity by 27% and doubled resistance exercise participation (1.0±1.8 to 2.0±2.1 days per week) whereas those who did not attend exercise classes (n=49) reduced moderate physical activity by 26% and did not change resistance exercise participation (interactions, p=0.04 and p=0.07, respectively). Patients who received resistance band instruction (n=15) from a kinesiologist had reductions in A1C (from 7.5±1.4 to 7.1±1.2; p=0.04), whereas other subgroups did not have significant changes in A1C.
  
  
  CONCLUSIONS
  Offering enhanced support for exercise at diabetes centres produced improvements in physical activity and exercise in type 2 diabetes patients. Resistance band instruction from a kinesiologist combined with participating in a walking and resistance training program improved glycemic control, which underscores the importance of including exercise professionals in diabetes management.
authors: Acadia University, Wolfville, Nova Scotia, Canada. Electronic address: jonathon.fowles@acadiau.ca.
authors: Jonathon R
authors: JR
authors: Fowles
authors: Acadia University, Wolfville, Nova Scotia, Canada.
authors: Chris
authors: C
authors: Shields
authors: Acadia University, Wolfville, Nova Scotia, Canada.
authors: Lisette
authors: L
authors: d'Entremont
authors: Acadia University, Wolfville, Nova Scotia, Canada.
authors: Stephanie
authors: S
authors: McQuaid
authors: Acadia University, Wolfville, Nova Scotia, Canada.
authors: Brittany
authors: B
authors: Barron
authors: Diabetes Care Program of Nova Scotia, Halifax, Nova Scotia, Canada.
authors: Peggy
authors: P
authors: Dunbar
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009674:Nova Scotia; D010358:Patient Participation
keywords: Diabetes Centres; Nouvelle-Écosse; Nova Scotia; Toolkit; action research; activité physique; boîte à outils; centres du diabète; diabète de type 2; exercice; exercise; physical activity; recherche participative; type 2 diabetes