title: Outcomes of a community-based lifestyle programme for adults with diabetes or pre-diabetes.
abstract: INTRODUCTION Diabetes, a long-term condition increasing in prevalence, requires ongoing healthcare management. Exercise alongside lifestyle education and support is effective for diabetes management. AIM To investigate clinical outcomes and acceptability of a community-based lifestyle programme for adults with diabetes/prediabetes at programme completion and 3-month follow-up. METHODS The 12-week community programme included twice-weekly sessions of self-management education and exercise, supervised by a physiotherapist, physiotherapy students and a nurse. Clinical outcomes assessed were cardiorespiratory fitness, waist circumference, exercise behaviour and self-efficacy. A standardised evaluation form was used to assess programme acceptability. RESULTS Clinically significant improvements were found from baseline (n = 36) to programme completion (n = 25) and 3-months follow-up (n = 20) for the six minute walk test (87 m (95%CI 65-109; p ≤ 0.01), 60 m (95%CI 21-100; p ≤ 0.01)), waist circumference (-3 cm (95%CI -6 to -1), -3 cm (95%CI -6 to 1)), exercise behaviour (aerobic exercise 53 min/week (95%CI 26 to 81; p ≤ 0.01), 71 min/week (95%CI 25 to 118; p ≤ 0.01)) and self-efficacy (0.7 (95%CI -0.2 to 1.6), 0.8 (95%CI 0.04 to 1.5)). Good programme acceptability was demonstrated by themes suggesting a culturally supportive, motivating, friendly, informative atmosphere within the programme. The attrition rate was 30% but there were no adverse medical events related to the programme. DISCUSSION The programme was safe and culturally acceptable and outcomes demonstrated clinical benefit to participants. The attrition rate was largely due to medical reasons unrelated to the programme. This model of a community-based lifestyle programme has the potential to be reproduced in other regions and in adults with similar long-term conditions. KEYWORDS Diabetes Mellitus Type II; Prediabetic state; Co-morbidity; Exercise; Self-management.
authors.forename: Chris
authors.initials: C
authors.lastname: Higgs
authors.forename: Margot
authors.initials: M
authors.lastname: Skinner
authors.forename: Leigh
authors.initials: L
authors.lastname: Hale
mesh_terms: D001794:Blood Pressure; D003153:Community Health Services / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D004032:Diet; D015444:Exercise; D005260:Female; D006040:Goals; D006801:Humans; D008019:Life Style; D008297:Male; D009520:New Zealand; D064686:Nutritionists / Q000458:organization & administration; D010353:Patient Education as Topic / Q000458:organization & administration; D010809:Physical Fitness; D059825:Physical Therapists / Q000458:organization & administration; D011236:Prediabetic State / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D055105:Waist Circumference