scholarly journals A systematic review of the behaviour change techniques and digital features in technology-driven type 2 diabetes prevention interventions

2020 ◽  
Vol 6 ◽  
pp. 205520762091442 ◽  
Author(s):  
Luke Van Rhoon ◽  
Molly Byrne ◽  
Eimear Morrissey ◽  
Jane Murphy ◽  
Jenny McSharry
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Behaviour Change ◽  
Diabetes Prevention ◽  
Behaviour Change Techniques ◽  
Significant Weight Loss ◽  
Effective Interventions ◽  
Prevention Interventions ◽  
Clinically Significant

Objectives Our aim was to conduct a systematic review to determine which technology-driven diabetes prevention interventions were effective in producing clinically significant weight loss, and to identify the behaviour change techniques and digital features frequently used in effective interventions. Methods We searched five databases (CINAHL, EMBASE, MEDLINE, PsychINFO, and Pubmed) from inception to September 2018 and reviewed 19 experimental and non-experimental studies of 21 technology-driven diet plus physical activity interventions for adults (≥18 years) at risk of developing type 2 diabetes. Behaviour change techniques were coded using the BCT taxonomy v1, and digital features were identified via thematic analysis of intervention descriptions. Results Sixty-three per cent of interventions were effective in the short term (achieving ≥3% weight loss at ≤6 months), using an average of 5.6 more behaviour change techniques than non-effective interventions, and 33% were effective in the long term (achieving ≥5% weight loss at ≥12 months), using 3.7 more behaviour change techniques than non-effective interventions. The techniques of social support (unspecified), goal setting (outcome/behaviour), feedback on behaviour, and self-monitoring of outcome(s) of behaviour were identified in over 90% of effective interventions. Interventions containing digital features that facilitated health and lifestyle education, behaviour/outcome tracking, and/or online health coaching were most effective. Conclusion The integration of specific behaviour change techniques and digital features may optimise digital diabetes prevention interventions to achieve clinically significant weight loss. Additional research is needed to identify the mechanisms in which behaviour change techniques and digital features directly influence physical activity, dietary behaviours, and intervention engagement.

scholarly journals Behaviour Change Techniques in Weight Gain Prevention Interventions in Adults of Reproductive Age: Meta-Analysis and Meta-Regression

Nutrients ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 209
Author(s):  
Mamaru Ayenew Awoke ◽  
Cheryce L. Harrison ◽  
Julie Martin ◽  
Marie L. Misso ◽  
Siew Lim ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Energy Intake ◽  
Behaviour Change ◽  
Meta Analysis ◽  
Reproductive Age ◽  
Behaviour Change Techniques ◽  
Weight Gain Prevention ◽  
Prevention Interventions ◽  
Meta Regression

Weight gain prevention interventions are likely to be more effective with the inclusion of behaviour change techniques. However, evidence on which behaviour change techniques (BCT) are most effective for preventing weight gain and improving lifestyle (diet and physical activity) is limited, especially in reproductive-aged adults. This meta-analysis and meta-regression aimed to identify BCT associated with changes in weight, energy intake and physical activity in reproductive-aged adults. BCT were identified using the BCT Taxonomy (v1) from each intervention. Meta-regression analyses were used to identify BCT associated with change in weight, energy intake and physical activity. Thirty-four articles were included with twenty-nine articles for the meta-analysis. Forty-three of the ninety-three possible BCT listed in the taxonomy were identified in the included studies. Feedback on behaviour and Graded tasks were significantly associated with less weight gain, and Review behaviour goals was significantly associated with lower energy intake. No individual BCT were significantly associated with physical activity. Our analysis provides further evidence for which BCT are most effective in weight gain prevention interventions. The findings support that the use of key BCT within interventions can contribute to successful weight gain prevention in adults of reproductive age.

A randomized trial to test the effectiveness of two technology-enhanced diabetes prevention programs in primary care: The DiaBEAT-it Study. (Preprint)

2021 ◽  
Author(s):  
Fabio Araujo Almeida ◽  
Wen You ◽  
Fabiana Almeida Brito ◽  
Thais Favero Alves ◽  
Cody L Goessl ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
At Risk ◽  
Weight Loss ◽  
Small Group ◽  
Diabetes Prevention ◽  
Action Plan ◽  
Activity Class

BACKGROUND Lifestyle interventions targeting physical activity and improved eating habits have demonstrated that modest weight loss can prevent or delay the onset of type-2 diabetes. However, translation of these interventions into typical clinical programs remains a challenge. OBJECTIVE To evaluate the effectiveness of two technology-enhanced interventions for diabetes prevention among adults at risk for developing diabetes in a primary care setting. METHODS The DiaBEAT-it study employed a hybrid 2-group preference (Choice) and 3-group randomized controlled (RCT) design. This paper presents the weight related primary outcomes of the RCT arm. Patients from Southwest Virginia were identified through the Carilion Clinic electronic health records. Eligible participants (18 and older, BMI≥25, no Type 2 Diabetes) were randomized to either Choice (n=264) or RCT (n=334). RCT individuals were further randomized to one of three groups: (1) a 2-hour small group class to help patients develop a personal action plan to prevent diabetes (SC, n=117); (2) a 2-hour small group class plus automated telephone calls using an interactive voice response system (IVR) to help participants initiate weight loss through a healthful diet and regular physical activity (Class/IVR, n=110); or (3) a DVD with same content as the class plus the same IVR calls over a period of 12 months (DVD/IVR, n=107). Height was assessed with a calibrated stadiometer, weight with a calibrated Health-O-Meter stand-on scale. RESULTS Intention to treat analyses, controlling for gender, race, age and baseline BMI, showed that DVD/IVR and Class/IVR led to reductions in BMI at 6 (DVD/IVR -0.94, p<.001; Class/IVR -0.70, p<.01), 12 (DVD/IVR -0.88, p<.001; Class/IVR-0.82, p<.001) and 18 (DVD/IVR -0.78, p<.001; Class/IVR -0.58, p<.01) months. All three groups showed a significant number of participants losing at least 5% of their body weight at 12 months (DVD/IVR 26.87%; Class/IVR 21.62%; SC 16.85%). When comparing groups, DVD/IVR were significantly more likely to decrease BMI at 6 months (p<.05) and maintain the reduction at 18 months (p<.05) when compared to SC. There were no differences between the other groups. CONCLUSIONS These findings suggest that both IVR delivered interventions were effective in reducing and maintaining weight reduction in a group of primary care patients at risk for developing type 2 diabetes. The DiaBEAT-it interventions show promise in responding to the need for scalable, effective methods to manage obesity and prevent diabetes in primary care settings that do not over burden primary care clinics and providers. CLINICALTRIAL clinicaltrials.gov NCT02162901, https://clinicaltrials.gov/ct2/show/NCT02162901 INTERNATIONAL REGISTERED REPORT RR2-doi: 10.1016/j.cct.2014.06.010

scholarly journals Identifying Barriers and Facilitators to Diet and Physical Activity Behaviour Change in Type 2 Diabetes Using a Design Probe Methodology

2021 ◽  
Vol 11 (2) ◽  
pp. 72
Author(s):  
Kevin A. Cradock ◽  
Leo R. Quinlan ◽  
Francis M. Finucane ◽  
Heather L. Gainforth ◽  
Kathleen A. Martin Ginis ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Behaviour Change ◽  
Design Research ◽  
Extended Period ◽  
Barriers And Facilitators ◽  
Behavioural Intervention ◽  
Behaviour Change Techniques ◽  
Diet And Physical Activity

Treatment of Type 2 Diabetes (T2D) typically involves pharmacological methods and adjunct behavioural modifications, focused on changing diet and physical activity (PA) behaviours. Changing diet and physical activity behaviours is complex and any behavioural intervention in T2D, to be successful, must use an appropriate suite of behaviour change techniques (BCTs). In this study, we sought to understand the perceived barriers and facilitators to diet and PA behaviour change in persons with T2D, with a view to creating artefacts to facilitate the required behaviour changes. The Design Probe was chosen as the most appropriate design research instrument to capture the required data, as it enabled participants to reflect and self-document, over an extended period of time, on their daily lived experiences and, following this reflection, to identify their barriers and facilitators to diet and PA behaviour change. Design Probes were sent to 21 participants and 13 were fully completed. A reflective thematic analysis was carried out on the data, which identified themes of food environment, mental health, work schedule, planning, social support, cravings, economic circumstances and energy associated with diet behaviour. Similar themes were identified for PA as well as themes of physical health, weather, motivation and the physical environment.

scholarly journals The theoretical basis of a nationally implemented type 2 diabetes prevention programme: how is the programme expected to produce changes in behaviour?

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Rhiannon E. Hawkes ◽  
Lisa M. Miles ◽  
David P. French
Keyword(s):  
Type 2 Diabetes ◽  
Behaviour Change ◽  
Staff Training ◽  
Diabetes Prevention ◽  
Logic Model ◽  
Prevention Programme ◽  
Behaviour Change Techniques ◽  
Behavioural Changes ◽  
Diabetes Prevention Programme

Abstract Background It is considered best practice to provide clear theoretical descriptions of how behaviour change interventions should produce changes in behaviour. Commissioners of the National Health Service Diabetes Prevention Programme (NHS-DPP) specified that the four independent provider organisations must explicitly describe the behaviour change theory underpinning their interventions. The nationally implemented programme, launched in 2016, aims to prevent progression to Type 2 diabetes in high-risk adults through changing diet and physical activity behaviours. This study aimed to: (a) develop a logic model describing how the NHS-DPP is expected to work, and (b) document the behaviour change theories underpinning providers’ NHS-DPP interventions. Methods A logic model detailing how the programme should work in changing diet and activity behaviours was extracted from information in three specification documents underpinning the NHS-DPP. To establish how each of the four providers expected their interventions to produce behavioural changes, information was extracted from their programme plans, staff training materials, and audio-recorded observations of mandatory staff training courses attended in 2018. All materials were coded using Michie and Prestwich’s Theory Coding Scheme. Results The NHS-DPP logic model included information provision to lead to behaviour change intentions, followed by a self-regulatory cycle including action planning and monitoring behaviour. None of the providers described an explicit logic model of how their programme will produce behavioural changes. Two providers stated their programmes were informed by the COM-B (Capability Opportunity Motivation – Behaviour) framework, the other two described targeting factors from multiple theories such as Self-Regulation Theory and Self-Determination Theory. All providers cited examples of proposed links between some theoretical constructs and behaviour change techniques (BCTs), but none linked all BCTs to specified constructs. Some discrepancies were noted between the theory described in providers’ programme plans and theory described in staff training. Conclusions A variety of behaviour change theories were used by each provider. This may explain the variation between providers in BCTs selected in intervention design, and the mismatch between theory described in providers’ programme plans and staff training. Without a logic model describing how they expect their interventions to work, justification for intervention contents in providers’ programmes is not clear.

What goes on in digital behaviour change interventions for weight loss maintenance targeting physical activity: A Scoping Review (Preprint)

2021 ◽  
Author(s):  
Jorge Encantado ◽  
António L. Palmeira ◽  
Carolina Silva ◽  
Falko F. Sniehotta ◽  
R. James Stubbs ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Behaviour Change ◽  
Mode Of Delivery ◽  
Weight Loss Maintenance ◽  
Mechanisms Of Action ◽  
Behaviour Change Techniques ◽  
Behavioural Interventions ◽  
Behaviour Change Interventions ◽  
Theoretical Approaches

BACKGROUND Behavioural interventions for weight loss maintenance have shown beneficial effects for weight loss maintenance. While the digital upgrade of behavioural interventions brings an enormous potential to tackle public health challenges, there is limited knowledge about the components of these interventions, i.e., its content, delivery and the theoretical approaches. OBJECTIVE To identify the core components of digital behaviour change interventions for weight loss maintenance targeting physical activity, in terms of: i) Behaviour Change Techniques; ii) Mechanisms of Action; iii) Modes of Delivery; iv) Dose; and v) Tailoring/Personalisation. In addition, the links between these components were investigated. METHODS A literature search was performed in 5 electronic databases: PubMed; Embase; CINHAL; PsycINFO, and Web of Science. Two reviewers independently screened the identified papers and extracted data related with the study characteristics and behaviour change techniques, mechanism of action, mode of delivery, dose, and tailoring, using standardized classifications whenever available (e.g., behaviour change techniques taxonomy). RESULTS Seventeen articles reporting eleven original studies were selected. Two studies were protocols, nine studies presented results for weight change and all but one showed no significant differences between the intervention and control groups. Eight studies (73%) provided adequate information on Behaviour Change Techniques. Five studies (45%) provided partial information about how the Behaviour Change Techniques were linked to mechanisms of action, and only one study (0.9%) described these links for all the techniques. Around half of the studies reported the modes through which behaviour change techniques were delivered. Descriptions of dose were present in most studies, but with minimal information. The use of tailoring or personalisation approaches was mentioned in eight studies (73%), but descriptions of what was tailored and how were minimal. CONCLUSIONS The compilation of information regarding intervention components was difficult due to the lack of information and systematisation in reporting across papers. This is particularly true for the reporting of the links between behaviour change techniques and the other core intervention components. This information is crucial to help us understand in the context of behaviour change interventions what works or does not work, how it works and why.

scholarly journals Health behaviour change considerations for weight loss and type 2 diabetes: nutrition, physical activity and sedentary behaviour

2020 ◽  
Vol 37 (6) ◽  
pp. 228
Author(s):  
Angel Marie Chater ◽  
Lindsey Smith ◽  
Louise Ferrandino ◽  
Kev Wyld ◽  
Daniel P Bailey
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Sedentary Behaviour ◽  
Behaviour Change ◽  
Health Behaviour ◽  
Health Behaviour Change

scholarly journals What goes on in digital behaviour change interventions for weight loss maintenance targeting physical activity: A Scoping Review

2021 ◽  
Author(s):  
Jorge Encantado ◽  
António L Palmeira ◽  
Carolina Silva ◽  
Falko Sniehotta ◽  
James Stubbs ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Behaviour Change ◽  
Partial Information ◽  
Mode Of Delivery ◽  
Weight Loss Maintenance ◽  
Mechanisms Of Action ◽  
Behaviour Change Techniques ◽  
Behavioural Interventions ◽  
Behaviour Change Interventions

Background: Behavioural interventions for weight loss maintenance have shown beneficial effects for weight loss maintenance. While the digital upgrade of behavioural interventions brings an enormous potential to tackle public health challenges, there is limited knowledge about the components of these interventions, i.e., its content, delivery and the theoretical approaches.Objective: To identify the core components of digital behaviour change interventions for weight loss maintenance targeting physical activity, in terms of: i) Behaviour Change Techniques; ii) Mechanisms of Action; iii) Modes of Delivery; iv) Dose; and v) Tailoring/Personalisation. In addition, the links between these components were investigated.Methods: A literature search was performed in 5 electronic databases: PubMed; Embase; CINHAL; PsycINFO, and Web of Science. Two reviewers independently screened the identified papers and extracted data related with the study characteristics and behaviour change techniques, mechanism of action, mode of delivery, dose, and tailoring, using standardized classifications whenever available (e.g., behaviour change techniques taxonomy). Results: Seventeen articles reporting eleven original studies were selected. Two studies were protocols, nine studies presented results for weight change and all but one showed no significant differences between the intervention and control groups. Eight studies (73%) provided adequate information on Behaviour Change Techniques. Five studies (45%) provided partial information about how the Behaviour Change Techniques were linked to mechanisms of action, and only one study (0.9%) described these links for all the techniques. Around half of the studies reported the modes through which behaviour change techniques were delivered. Descriptions of dose were present in most studies, but with minimal information. The use of tailoring or personalisation approaches was mentioned in eight studies (73%), but descriptions of what was tailored and how were minimal. Conclusions: The compilation of information regarding intervention components was difficult due to the lack of information and systematisation in reporting across papers. This is particularly true for the reporting of the links between behaviour change techniques and the other core intervention components. This information is crucial to help us understand in the context of behaviour change interventions what works or does not work, how it works and why.

scholarly journals Optimisation of the ActWELL lifestyle intervention programme for women attending routine NHS breast screening clinics.

2020 ◽  
Author(s):  
Annie Anderson ◽  
Angela M. Craigie ◽  
Stephanie Gallant ◽  
Chloe McAdam ◽  
E. Jane Macaskill ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Weight Loss ◽  
Weight Management ◽  
Behaviour Change ◽  
Breast Screening ◽  
Feasibility Trial ◽  
Behaviour Change Techniques ◽  
Peer Reviewers ◽  
Post Menopausal

Abstract Background Around 30% of post-menopausal breast cancer is related to excess body fat, alcohol intake and low levels of physical activity. Current estimates suggest that there is a 12% increased risk in post-menopausal breast cancer for every 5kg/m 2 increase in Body Mass Index (BMI). Despite this evidence there are few lifestyle programmes directed towards breast cancer risk reduction. This paper describes the process of optimising of the ActWELL programme which aims to support weight management in women invited to attend routine NHS breast screening clinics. Methods A feasibility study of a prototype programme aiming to change lifestyle behaviours was successfully undertaken. The programme used educational approaches and behaviour change techniques delivered by lifestyle coaches using individual face to face meetings and telephone sessions. To optimise the intervention for a definitive randomised controlled trial of weight management, data from the feasibility trial, focus group discussions conducted with the target population, feedback from the trial public advisory group and comments from peer reviewers were obtained. Concepts from implementation research provided further guidance to assist in the refinement of the intervention which was then discussed and agreed by all investigators and the trial steering group. Results The results from the feasibility trial were considered appropriate for moving on to a full trial with 70% of participants finding the programme acceptable. The primary outcomes (weight loss and physical activity) provided an important focus for design input from the target group. The contributions highlighted the need to review programme duration, coach contact time, content and use of behaviour change techniques as well as communications generally (e.g. science and evidence, non-judgemental approaches and avoiding guilt). In addition, the need for emphasis on support rather than education became apparent. The recommendations from peer reviewers focussed on the magnitude of effort required to achieve the intended weight loss and weight loss maintenance. Implementation science supported the use of the capability/opportunity/motivation (COM- B)model in overall design. Conclusions The optimisation process has facilitated the development and evaluation of a programme which enables the delivery of a promising intervention to achieve weight management in post-menopausal women.

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