title: A randomised controlled trial of a physical activity and nutrition program targeting middle-aged adults at risk of metabolic syndrome in a disadvantaged rural community.
abstract: BACKGROUND
  Approximately 70% of Australian adults aged over 50 are overweight or obese, with the prevalence significantly higher in regional/remote areas compared to cities. This study aims to determine if a low-cost, accessible lifestyle program targeting insufficiently active adults aged 50-69 y can be successfully implemented in a rural location, and whether its implementation will contribute to the reduction/prevention of metabolic syndrome, or other risk factors for type 2 diabetes, and cardiovascular disease.
  
  
  METHODS
  This 6-month randomised controlled trial will consist of a nutrition, physical activity, and healthy weight intervention for 50-69 year-olds from a disadvantaged rural community. Five hundred participants with central obesity and at risk of metabolic syndrome will be recruited from Albany and surrounding areas in Western Australia (within a 50 kilometre radius of the town). They will be randomly assigned to either the intervention (n = 250) or wait-listed control group (n = 250). The theoretical concepts in the study utilise the Self-Determination Theory, complemented by Motivational Interviewing. The intervention will include a custom-designed booklet and interactive website that provides information, and encourages physical activity and nutrition goal setting, and healthy weight management. The booklet and website will be supplemented by an exercise chart, calendar, newsletters, resistance bands, accelerometers, and phone and email contact from program staff. Data will be collected at baseline and post-intervention.
  
  
  CONCLUSIONS
  This study aims to contribute to the prevention of metabolic syndrome and inter- related chronic illnesses: type 2 diabetes mellitus, cardiovascular disease, and some cancers; which are associated with overweight/obesity, physical inactivity, and poor diet. This large rural community-based trial will provide guidelines for recruitment, program development, implementation, and evaluation, and has the potential to translate findings into practice by expanding the program to other regional areas in Australia.
  
  
  BACKGROUND
  Australian and New Zealand Clinical Trials Registry [ ACTRN12614000512628 , registration date 14(th) May 2014].
authors.affiliation: Collaboration for Evidence, Research and Impact in Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. k.blackford@curtin.edu.au.|Centre for Behavioural Research in Cancer Control, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. k.blackford@curtin.edu.au.|School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. k.blackford@curtin.edu.au.
authors.forename: Krysten
authors.initials: K
authors.lastname: Blackford
authors.affiliation: Collaboration for Evidence, Research and Impact in Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. j.jancey@curtin.edu.au.|Centre for Behavioural Research in Cancer Control, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. j.jancey@curtin.edu.au.|School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. j.jancey@curtin.edu.au.
authors.forename: Jonine
authors.initials: J
authors.lastname: Jancey
authors.affiliation: Collaboration for Evidence, Research and Impact in Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. andy.lee@curtin.edu.au.|Centre for Behavioural Research in Cancer Control, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. andy.lee@curtin.edu.au.|School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. andy.lee@curtin.edu.au.
authors.forename: Andy H
authors.initials: AH
authors.lastname: Lee
authors.affiliation: School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. t.p.james@curtin.edu.au.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: James
authors.affiliation: Collaboration for Evidence, Research and Impact in Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. p.howat@curtin.edu.au.|Centre for Behavioural Research in Cancer Control, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. p.howat@curtin.edu.au.|School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. p.howat@curtin.edu.au.
authors.forename: Peter
authors.initials: P
authors.lastname: Howat
authors.affiliation: School of Exercise and Nutrition Sciences, Queensland University of Technology, GPO Box 2434, Brisbane, QLD, 4001, Australia. ahills@mmri.mater.org.au.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Hills
authors.affiliation: Centre for Public Health Nutrition Research, Division of Cancer Research, Ninewells Medical School, Level 7, Mailbox 7, Dundee, DD1 9SY, UK. a.s.anderson@dundee.ac.uk.
authors.forename: Annie
authors.initials: A
authors.lastname: Anderson
mesh_terms: D000368:Aged; D001315:Australia; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000517:prevention & control*; D008875:Middle Aged; D062405:Motivational Interviewing / Q000379:methods*; D009520:New Zealand; D009752:Nutritional Status; D009765:Obesity / Q000628:therapy*; D010174:Pamphlets; D012424:Rural Population; D014904:Western Australia