title: Adoption and maintenance of gym-based strength training in the community setting in adults with excess weight or type 2 diabetes: a randomized controlled trial.
abstract: BACKGROUND
  Participant adoption and maintenance is a major challenge in strength training (ST) programs in the community-setting. In adults who were overweight or with type 2 diabetes (T2DM), the aim of this study was to compare the effectiveness of a standard ST program (SST) to an enhanced program (EST) on the adoption and maintenance of ST and cardio-metabolic risk factors and muscle strength.
  
  
  METHODS
  A 12-month cluster-randomized controlled trial consisting of a 6-month adoption phase followed by a 6-month maintenance phase. In 2008-2009, men and women aged 40-75 years (n = 318) with T2DM (n = 117) or a BMI >25 (n = 201) who had not participated in ST previously were randomized into either a SST or an EST program (which included additional motivationally-tailored behavioral counselling). Adoption and maintenance were defined as undertaking ≥ 3 weekly gym-based exercise sessions during the first 6-months and from 6-12 months respectively and were assessed using a modified version of the CHAMPS (Community Healthy Activity Models Program for Seniors) instrument.
  
  
  RESULTS
  Relative to the SST group, the adjusted odds ratio (OR) of adopting ST for all participants in the EST group was 3.3 (95 % CI 1.2 to 9.4). In stratified analyses including only those with T2DM, relative to the SST group, the adjusted OR of adopting ST in the EST group was 8.2 (95 % CI 1.5-45.5). No significant between-group differences were observed for maintenance of ST in either pooled or stratified analyses. In those with T2DM, there was a significant reduction in HbA1c in the EST compared to SST group during the adoption phase (net difference, -0.13 % [-0.26 to -0.01]), which persisted after 12-months (-0.17 % [-0.3 to -0.05]).
  
  
  CONCLUSIONS
  A behaviorally-focused community-based EST intervention was more effective than a SST program for the adoption of ST in adults with excess weight or T2DM and led to greater improvements in glycemic control in those with T2DM.
  
  
  BACKGROUND
  Registered at ACTRN12611000695909 (Date registered 7/7/2011).
authors: Deakin University, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Melbourne, Victoria, Australia. mteych@deakin.edu.au.
authors: Megan
authors: M
authors: Teychenne
authors: Deakin University, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Melbourne, Victoria, Australia. kball@deakin.edu.au.
authors: Kylie
authors: K
authors: Ball
authors: Deakin University, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Melbourne, Victoria, Australia. jo.salmon@deakin.edu.au.
authors: Jo
authors: J
authors: Salmon
authors: Deakin University, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Melbourne, Victoria, Australia. robin.daly@deakin.edu.au.
authors: Robin M
authors: RM
authors: Daly
authors: Deakin University, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Melbourne, Victoria, Australia. david.crawford@deakin.edu.au.
authors: David A
authors: DA
authors: Crawford
authors: Baker IDI Heart and Diabetes Institute, Melbourne, Australia. Parneet.Sethi@bakeridi.edu.au.
authors: Parneet
authors: P
authors: Sethi
authors: Deakin University, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Melbourne, Victoria, Australia. michelle@michellejorna.com.|Baker IDI Heart and Diabetes Institute, Melbourne, Australia. michelle@michellejorna.com.
authors: Michelle
authors: M
authors: Jorna
authors: Deakin University, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Melbourne, Victoria, Australia. David.Dunstan@bakeridi.edu.au.|Baker IDI Heart and Diabetes Institute, Melbourne, Australia. David.Dunstan@bakeridi.edu.au.|School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia. David.Dunstan@bakeridi.edu.au.|Cancer Prevention Research Centre, School of Population Health, The University of Queensland, Brisbane, Australia. David.Dunstan@bakeridi.edu.au.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. David.Dunstan@bakeridi.edu.au.
authors: David W
authors: DW
authors: Dunstan
mesh_terms: D001521:Behavior Therapy; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D053580:Muscle Strength; D009765:Obesity / Q000150:complications; D050177:Overweight; D015397:Program Evaluation; D012111:Residence Characteristics; D055070:Resistance Training; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin