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dc.contributor.advisorJames A. Fain
dc.contributor.authorAllen, Nancy A.
dc.date2022-08-11T08:09:03.000
dc.date.accessioned2022-08-23T16:16:35Z
dc.date.available2022-08-23T16:16:35Z
dc.date.issued2006-10-26
dc.date.submitted2007-09-05
dc.identifier.doi10.13028/z61a-vw08
dc.identifier.urihttp://hdl.handle.net/20.500.14038/34364
dc.description.abstractUp to 60% of individuals with type 2 diabetes (T2DM) do not participate in regular physical activity (PA) despite the known benefits. To encourage these individuals to increase PA behavior, this study tested the feasibility and implementation of a nurse-directed counseling intervention using continuous glucose monitoring system (CGMS). The study used a framework derived from self-efficacy theory to 1) compare changes in self-efficacy, BP and activity counts between participants receiving CGMS counseling and standard T2DM counseling, 2) examine relationships between PA self-efficacy and BP and activity counts, 3) evaluate recruitment, retention, and screening strategies, and 4) assess instrument reliability and utility. Adults (N=52) with T2DM (non-insulin requiring, inactive) were randomized to intervention (n=27) or control groups (n=25). Both groups received 90 minutes of diabetes education with a follow-up phone call at 4 weeks. The intervention group also received feedback on their own CGMS graphs and a role model's graph depicting PA related reductions in glucose levels. PA benefits/barriers were discussed and goals were set. Outcomes were recorded at 1 and 8 weeks. Participants were older (57±14 years), predominantly (90%) white, about half (52%) female, and had diabetes for 8±7 years. Relative to the control group, participants receiving the intervention had higher self-efficacy scores at 8 weeks, indicating more confidence in sticking to a PA program. Their light/sedentary activity minutes decreased significantly and moderate activity minutes increased significantly; systolic BP, A1c and BMI decreased significantly. Only self-efficacy for "Sticking to it" was positively associated with moderate activity. The most successful recruitment media was multiple newspaper press releases. Most referrals came from endocrinology physicians. Of 231 study volunteers, 106 did not meet the criterion of A1c≥7.5%. These data suggest that CGMS feedback is feasible for counseling individuals with T2DM to improve PA and may improve risk factors for diabetes-related complications. Newspaper press releases are effective for recruiting participants with T2DM. Less restrictive inclusion criteria in a larger study may allow more participation by sedentary individuals with T2DM but may reduce effect size. CGMS was well tolerated and its data aided diabetes-related teaching.
dc.language.isoen_US
dc.rightsCopyright is held by the author, with all rights reserved.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectDiabetes Mellitus
dc.subjectMotor Activity
dc.subjectSelf Efficacy
dc.subjectNurse-Patient Relations
dc.subjectBlood Glucose Self-Monitoring
dc.subjectBehavior and Behavior Mechanisms
dc.subjectEndocrine System Diseases
dc.subjectNursing
dc.titleChanging Physical Activity Behavior with Continuous Glucose Monitoring: A Dissertation
dc.typeDoctoral Dissertation
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1001&context=gsn_diss&unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/gsn_diss/2
dc.identifier.contextkey360661
refterms.dateFOA2022-08-26T04:13:05Z
html.description.abstract<p>Up to 60% of individuals with type 2 diabetes (T2DM) do not participate in regular physical activity (PA) despite the known benefits. To encourage these individuals to increase PA behavior, this study tested the feasibility and implementation of a nurse-directed counseling intervention using continuous glucose monitoring system (CGMS). The study used a framework derived from self-efficacy theory to 1) compare changes in self-efficacy, BP and activity counts between participants receiving CGMS counseling and standard T2DM counseling, 2) examine relationships between PA self-efficacy and BP and activity counts, 3) evaluate recruitment, retention, and screening strategies, and 4) assess instrument reliability and utility.</p> <p>Adults (<em>N</em>=52) with T2DM (non-insulin requiring, inactive) were randomized to intervention (<em>n</em>=27) or control groups (<em>n</em>=25). Both groups received 90 minutes of diabetes education with a follow-up phone call at 4 weeks. The intervention group also received feedback on their own CGMS graphs and a role model's graph depicting PA related reductions in glucose levels. PA benefits/barriers were discussed and goals were set. Outcomes were recorded at 1 and 8 weeks.</p> <p>Participants were older (57±14 years), predominantly (90%) white, about half (52%) female, and had diabetes for 8±7 years. Relative to the control group, participants receiving the intervention had higher self-efficacy scores at 8 weeks, indicating more confidence in sticking to a PA program. Their light/sedentary activity minutes decreased significantly and moderate activity minutes increased significantly; systolic BP, A1<sub>c</sub> and BMI decreased significantly. Only self-efficacy for "Sticking to it" was positively associated with moderate activity. The most successful recruitment media was multiple newspaper press releases. Most referrals came from endocrinology physicians. Of 231 study volunteers, 106 did not meet the criterion of A1<sub>c</sub>≥7.5%.</p> <p>These data suggest that CGMS feedback is feasible for counseling individuals with T2DM to improve PA and may improve risk factors for diabetes-related complications. Newspaper press releases are effective for recruiting participants with T2DM. Less restrictive inclusion criteria in a larger study may allow more participation by sedentary individuals with T2DM but may reduce effect size. CGMS was well tolerated and its data aided diabetes-related teaching.</p>
dc.identifier.submissionpathgsn_diss/2
dc.contributor.departmentGraduate School of Nursing


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