title: Rationale and study protocol for the 'eCoFit' randomized controlled trial: Integrating smartphone technology, social support and the outdoor physical environment to improve health-related fitness among adults at risk of, or diagnosed with, Type 2 Diabetes.
abstract: The prevalence and risk of Type 2 Diabetes (T2D) has dramatically increased over the past decade. Physical activity (PA) has significant benefits for the treatment and prevention of T2D. The aim of this study is to develop, implement and evaluate a community-based PA intervention to improve aerobic and muscular fitness among adults at risk of, or diagnosed with T2D.
  
  
  
  The eCoFit pilot intervention will be evaluated using a randomized controlled trial (RCT) design. The 20-week (Phases 1 and 2) multi-component intervention was guided by Social Cognitive Theory, Health Action Process Approach Model, and Cognitive Behavior Therapy strategies. Phase 1 (Weeks 1-10) includes: i) 5 group face-to-face sessions consisting of outdoor training and cognitive mentoring; and ii) the use of the eCoFit smartphone application with a description of where and how to use the outdoor environment to be more physically active. Phase 2 (Weeks 11-20) includes the use of the eCoFit smartphone application only. Assessments are to be conducted at baseline, 10-weeks (primary end-point) and 20-weeks (secondary end-point) post-baseline. Primary outcomes are cardio-respiratory fitness and muscular fitness (lower body). Secondary outcomes include physical, behavioral, mental health and quality of life, and social-cognitive outcomes.
  
  
  
  eCoFit is an innovative, multi-component intervention, which integrates smartphone technology, social support and the outdoor physical environment to promote aerobic and resistance training PA among adults at risk of, or diagnosed with T2D. The findings will be used to guide future interventions and to develop and implement effective community-based prevention programs.
  
  
  
  Australian New Zealand Clinical Trials Registry No: ACTRN12615000990527.
authors.affiliation: Priority Research Centre for Physical Activity and Nutrition, Advance Technology Centre, Level 3, The University of Newcastle, Australia.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Wilczynska
authors.affiliation: Priority Research Centre for Physical Activity and Nutrition, Advance Technology Centre, Level 3, The University of Newcastle, Australia.
authors.forename: David R
authors.initials: DR
authors.lastname: Lubans
authors.affiliation: Priority Research Centre for Physical Activity and Nutrition, Advance Technology Centre, Level 3, The University of Newcastle, Australia.
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Cohen
authors.affiliation: Priority Research Centre for Physical Activity and Nutrition, Advance Technology Centre, Level 3, The University of Newcastle, Australia.
authors.forename: Jordan J
authors.initials: JJ
authors.lastname: Smith
authors.affiliation: Priority Research Centre for Physical Activity and Nutrition, Advance Technology Centre, Level 3, The University of Newcastle, Australia.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Robards
authors.affiliation: Priority Research Centre for Physical Activity and Nutrition, Advance Technology Centre, Level 3, The University of Newcastle, Australia. Electronic address: ron.plotnikoff@newcastle.edu.au.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Plotnikoff
mesh_terms: D000328:Adult; D001315:Australia; D000072599:Cardiorespiratory Fitness; D015928:Cognitive Behavioral Therapy; D003924:Diabetes Mellitus, Type 2 / Q000534:rehabilitation*; D004777:Environment; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D063731:Mobile Applications; D053580:Muscle Strength; D050177:Overweight / Q000534:rehabilitation*; D010809:Physical Fitness; D010865:Pilot Projects; D011582:Psychological Theory; D011788:Quality of Life; D012306:Risk; D000068997:Smartphone; D012944:Social Support
keywords: Outdoor physical environment; Physical activity; Pre-diabetes; Smartphone application (app); Social support; Type 2 Diabetes (T2D)