title: Effectiveness of Personalized Feedback Alone or Combined with Peer Support to Improve Physical Activity in Sedentary Older Malays with Type 2 Diabetes: A Randomized Controlled Trial.
abstract: BACKGROUND
  Regular physical activity is an important aspect of self-management among older people with type 2 diabetes but many remain inactive. Interventions to improve physical activity levels have been studied but few studies have evaluated the effects of personalized feedback (PF) or peer support (PS); and there was no study on older people of Asian heritage. Hence, this trial evaluated whether PF only or combined with PS improves physical activity among older Malays with type 2 diabetes (T2DM) compared to usual care only.
  
  
  METHODS
  A three-arm randomized controlled trial was conducted in a primary healthcare clinic in Malaysia. Sixty-nine sedentary Malays aged 60 years and older with T2DM who received usual diabetes care were randomized to PF or PS interventions or as controls for 12 weeks with follow-ups at weeks 24 and 36. Intervention groups performed unsupervised walking activity and received written feedback on physical activity. The PS group also received group and telephone contacts from trained peer mentors. The primary outcome was pedometer steps. Secondary outcomes were self-reported physical activity, cardiovascular risk factors, cardiorespiratory fitness, balance, quality of life, and psychosocial wellbeing.
  
  
  RESULTS
  Fifty-two (75.4%) completed the 36-week study. The PS group showed greater daily pedometer readings than the PF and controls (p = 0.001). The PS group also had greater improvement in weekly duration (p < 0.001) and frequency (p < 0.001) of moderate intensity physical activity, scores on the Physical Activity Scale for Elderly (p = 0.003), 6-min walk test (p < 0.001), and social support from friends (p = 0.032) than PF and control groups.
  
  
  CONCLUSIONS
  The findings suggest that PF combined with PS in older Malays with T2DM improved their physical activity levels, cardiorespiratory fitness, and support from friends.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN71447000.
authors.affiliation: Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia , Serdang, Selangor , Malaysia.
authors.forename: Shariff-Ghazali
authors.initials: SG
authors.lastname: Sazlina
authors.affiliation: Royal District Nursing Service Limited, RDNS Research Institute , St. Kilda, VIC , Australia.
authors.forename: Colette Joy
authors.initials: CJ
authors.lastname: Browning
authors.affiliation: Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia , Bandar Sunway, Selangor , Malaysia.
authors.forename: Shajahan
authors.initials: S
authors.lastname: Yasin
keywords: elderly Malays; peer support; personalized feedback; physical activity; type 2 diabetes mellitus