Behavioral strategies in diabetes prevention programs: A systematic review of randomized controlled trials

Baker, Michael K.; Simpson, Kylie; Lloyd, Bradley; Bauman, Adrian E.; Singh, Maria A. Fiatarone

doi:10.1016/j.diabres.2010.06.030

« Previous Next »Diabetes Research and Clinical Practice
Volume 91, Issue 1 , Pages 1-12, January 2011

Behavioral strategies in diabetes prevention programs: A systematic review of randomized controlled trials

Michael K. Baker
- Boden Institute of Obesity, Nutrition and Exercise, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
- Corresponding author. Tel.: +61 2 9351 9858; fax: +61 2 9351 9204.
Kylie Simpson
- Exercise Health and Performance, The University of Sydney, Lidcombe, Australia
Bradley Lloyd
- Exercise Health and Performance, The University of Sydney, Lidcombe, Australia
Adrian E. Bauman
- School of Public Health, The University of Sydney, Camperdown, Australia
Maria A. Fiatarone Singh
- Boden Institute of Obesity, Nutrition and Exercise, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
- Hebrew Senior Life and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA USA

Received 24 May 2010; received in revised form 22 June 2010; accepted 28 June 2010. published online 26 July 2010.

Abstract

The worldwide epidemic of type 2 diabetes (T2D) emphasizes the need for guidelines regarding community implementation of lifestyle modification prevention programs. An understanding of effective behavioral strategies is needed if evidence translation is to be realized. The aim of this paper is to systematically review the behavioral change strategies for lifestyle T2D prevention programs.

Methods

Randomized controlled trials (RCTs) of lifestyle interventions for the prevention of T2D were reviewed with a systematic literature search. Data relating to the behavioral strategies and trial outcomes were extracted.

Results

Overall, lifestyle interventions were successful in reducing the incidence of T2D. The behavioral strategies utilized in these interventions were drawn from a variety of theoretical backgrounds. All RCTs utilized intensive modes of delivery and were associated with low dropout rates of 5.5–13.4%.

Conclusions

The available evidence shows that a robust behavioral change strategy is an essential part of an effective lifestyle modification program, as the absence of intensive individualized advice or “information only” more closely resembles the control group interventions used in these RCTs.

Keywords: Diabetes mellitus type 2, Diet therapy, Exercise, Health behavior, Lifestyle