title: Setting Single or Multiple Goals for Diet and Physical Activity Behaviors Improves Cardiovascular Disease Risk Factors in Adults With Type 2 Diabetes: A Pragmatic Pilot Randomized Trial.
abstract: The purpose of this study was to evaluate a 4-month telephone-based goal-setting and decision support intervention among adults with type 2 diabetes mellitus (T2DM) and multiple risk factors for cardiovascular disease (CVD).
  
  
  
  A randomized pretest-posttest control group design was employed. Overweight or obese adults aged 40 to 75 years with T2DM and ≥1 additional CVD risk factor were provided with individualized CVD risk information. At baseline and each biweekly telephone call, the multiple-goal group self-selected both diet- and physical activity-related goals, the single goal group set a single goal, and the control group received information about community health resources. Dietary intake was assessed via a food frequency questionnaire, physical activity via questionnaire, and A1C and blood lipids via fasting fingerstick sample. Between-group differences for clinical (ie, A1C, blood pressure, and blood lipids), physical activity, and dietary variables were evaluated using Kruskal-Wallis, Mann-Whitney U, analysis of variance, and t tests.
  
  
  
  From pre- to postintervention, the single-goal group demonstrated significant improvement in systolic blood pressure and intake of servings of fruits, vegetables, and refined grains (all P < .05). The multiple-goal group reported significant reduction in percent energy from total, saturated, monounsaturated, and trans fat intake and significant increase in leisure time walking (all P < .05).
  
  
  
  A multiple-goal approach over 4 months can improve dietary and physical activity outcomes, while a single-goal approach may facilitate improvement in one behavioral domain. Additional research is needed to evaluate maintenance of the achieved changes.
authors.affiliation: Department of Human Sciences, Human Nutrition, Ohio State University, OH (Ms Swoboda, Dr Miller)
authors.forename: Christine M
authors.initials: CM
authors.lastname: Swoboda
authors.affiliation: Department of Human Sciences, Human Nutrition, Ohio State University, OH (Ms Swoboda, Dr Miller)
authors.forename: Carla K
authors.initials: CK
authors.lastname: Miller
authors.affiliation: College of Nursing, Ohio State University, OH (Dr Wills)
authors.forename: Celia E
authors.initials: CE
authors.lastname: Wills
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D003661:Decision Support Techniques; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology / Q000628:therapy*; D003927:Diet, Diabetic / Q000523:psychology*; D015444:Exercise / Q000523:psychology*; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D009765:Obesity / Q000523:psychology; D050177:Overweight / Q000523:psychology; D010865:Pilot Projects; D012307:Risk Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers