A Translational Worksite Diabetes Prevention Trial Improves Psychosocial Status, Dietary Intake, and Step Counts among Employees with Prediabetes: A Randomized Controlled Trial

Carla K Miller, Kellie Weinhold, David G Marrero, Haikady N Nagaraja, Brian C Focht, Carla K Miller, Kellie Weinhold, David G Marrero, Haikady N Nagaraja, Brian C Focht

Abstract

Objective: Few worksite trials have examined the impact of diabetes prevention interventions on psychological and behavioral outcomes. Thus, the impact of a worksite lifestyle intervention on psychosocial outcomes, food group intake, and step counts for physical activity (PA) was evaluated.

Method: A randomized pretest/posttest control group design with 3-month follow-up was employed from October 2012 to May 2014 at a U.S. university worksite among employees with prediabetes. The experimental group (n=35) received a 16-week group-based intervention while the control group received usual care (n=33). Repeated measures analysis of variance compared the change in outcomes between groups across time.

Results: A significant difference occurred between groups post-intervention for self-efficacy associated with eating and PA; goal commitment and difficulty; satisfaction with weight loss and physical fitness; peer social support for healthful eating; generation of alternatives for problem solving; and intake of fruits, meat, fish, poultry, nuts, and seeds (all ps < .05). The experimental group significantly increased step counts post-intervention (p = .0279) and were significantly more likely to report completing their work at study end (p = .0231).

Conclusion: The worksite trial facilitated improvement in modifiable psychosocial outcomes, dietary patterns, and step counts; the long-term impact on diabetes prevention warrants further investigation.

Trial registration: ClinicalTrials.gov identifier: NCT01682954.

Keywords: dietary intake; goal setting; physical activity; prediabetes; randomized controlled trial; self-efficacy.

Figures

Fig. 1
Fig. 1
CONSORT diagram of participant enrollment, allocation, and analyses.

References

    1. Ackermann R.T., Finch E.A., Brizendine E., Zhou H., Marrero D.G. Translating the Diabetes Prevention Program into the community: the DEPLOY pilot study. Am. J. Prev. Med. 2008;35:357–363.
    1. American Diabetes Association Are you at risk for type 2 diabetes? Diabetes risk test. Available at. (Accessed July 10, 2014)
    1. Block G., Woods M., Potosky A., Clifford C. Validation of a self-administered diet history questionnaire using multiple diet records. J. Clin. Epidemiol. 1990;43:1327–1335.
    1. Bullard K.M., Saydah S.H., Imperatore G. Secular changes in U.S. prediabetes prevalence defined by hemoglobin A1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999–2010. Diabetes Care. 2013;36:2286–2293.
    1. Conn V.S., Hafdahl A.R., Cooper P.S., Brown L.M., Lusk S.L. Meta-analysis of workplace physical activity interventions. Am. J. Prev. Med. 2009;37:330–339.
    1. D'Zurilla T.J., Nezu A.M. Springer Publishing Company; New York: 2007. Problem-Solving Therapy: A Positive Approach to Clinical Intervention.
    1. D'Zurilla T.J., Nezu A.M., Maydeu-Olivares A. Multi-Health Systems, Inc.; North Tonawanda, NY: 2002. Social Problem-Solving Inventory-Revised Technical Manual.
    1. Delahanty L.M., Conroy M.B., Nathan D.M., for the Diabetes Prevention Program Research Group Psychological predictors of physical activity in the Diabetes Prevention Program. J. Am. Diet. Assoc. 2006;106:698–705.
    1. Delahanty L.M., Peyrot M., Shrader P.J., Williamson D.A., Meigs J.B., Nathan D.M., for the DPP Research Group Pretreatment, psychological, and behavioral predictors of weight outcomes among lifestyle intervention participants in the Diabetes Prevention Program (DPP) Diabetes Care. 2013;36:34–40.
    1. Diabetes Prevention Program (DPP) Research Group The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care. 2002;25:2165–2171.
    1. Erez M., Zidon I. Effect of goal acceptance on the relationship of goal difficulty to performance. J. Appl. Psychol. 1984;69:69–78.
    1. Gardner C.D., Kiazand A., Alhassan S. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women. JAMA. 2007;297:969–977.
    1. Glasgow R.E., Terborg J.R., Strycker L.A., Boles S.M., Hollis J.F. Take Heart II: replication of a worksite health promotion trial. J. Behav. Med. 1997;20:143–161.
    1. Goetzel R.Z., Ozminkowski R.J. The health and cost benefits of work site health-promotion programs. Annu. Rev. Public Health. 2008;29:303–323.
    1. Jaacks L.M., Ma Y., Davis N., for the Diabetes Prevention Program Research Group Long-term changes in dietary and food intake behavior in the Diabetes Prevention Program Outcomes Study. DiabetMed. 2014
    1. Katula J.A., Vitolins M.Z., Rosenberger E.L. One-year results of a community-based translation of the Diabetes Prevention Program. Diabetes Care. 2011;34:1451–1457.
    1. Knowler W.C., Barrett-Connor E., Fowler S.E., for the Diabetes Prevention Program Research Group Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med. 2002;346:393–403.
    1. Koopman C., Pelletier K., Murray J.F. Stanford Presenteeism Scale: health status and employee productivity. J. Occup. Environ. Med. 2002;44:14–20.
    1. Kristal A.R., Glanz K., Tilley B.C., Li S. Mediating factors in dietary change: understanding the impact of a worksite nutrition intervention. Health Educ. Behav. 2000;27:112–125.
    1. Ma J., Yank B., Xiao L. Translating the Diabetes Prevention Program lifestyle intervention for weight loss into primary care. JAMA Int. Med. 2013;173:113–121.
    1. Mares-Perlman J.A., Klein B.E.K., Klein R., Ritter L.L., Fisher M.R., Freudenheim J.L. A diet history questionnaire ranks nutrient intakes in middle-aged and older men and women similarly to multiple food records. J. Nutr. 1993;123:489–501.
    1. McEvoy C.T., Cardwell C.R., Woodside J.V., Young I.S., Hunter S.J., McKinley M.C. A posteriori dietary patterns are related to risk of type 2 diabetes: findings from a systematic review and meta-analysis. J. Acad. Nutr. Diet. 2014;114:1759–1775.
    1. Morgan P.J., Callister R., Collins C.E. The SHED-IT community trial: a randomized controlled trial of internet- and paper-based weight loss programs tailored for overweight and obese men. Ann. Behav. Med. 2013;45:139–152.
    1. Pan X.R., Li G.W., Hu Y.H. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study. Diabetes Care. 1997;20:537–544.
    1. Reboussin B.A., Rejeski W.J., Martin K.A. Correlates of satisfaction with body function and body appearance in middle- and older aged adults: the Activity Counseling Trial (ACT) Psychol. Health. 2000;15:239–254.
    1. Rock C.L., Flatt S.W., Sherwood N.E., Karanja N., Pakiz B., Thomson C.A. Effect of a free prepared meal and incentivized weight loss program on weight loss and weight loss maintenance in obese and overweight women: a randomized controlled trial. JAMA. 2010;304:1803–1811.
    1. Sallis F.J., Grossman R.M., Pinski R.B., Patterson T.L., Nader P.R. The development of scales to measure social support for diet and exercise behaviors. Prev. Med. 1987;16:825–836.
    1. Sallis J.F., Pinski R.B., Grossman R.M., Patterson T.L., Nader P.R. The development of self-efficacy scales for health-related diet and exercise behaviors. Health Educ. Res. 1988;3:283–292.
    1. Scott T., Reading J., Shephard R.J. Revision of the Physical Activity Readiness Questionnaire (PAR-Q) Can. J. Sport Sci. 1992;17:338–345.
    1. Seidel M.C., Powell R.O., Zgibor J.C., Siminerio L.M., Piatt G.A. Translating the Diabetes Prevention Program into an urban medically underserved community. Diabetes Care. 2008;31:684–689.
    1. Seijts G.H., Latham G.P. The construct of goal commitment: measurement and relationships with task performance. In: Goffin R.D., Helmes E., editors. Problems and Solutions in Human Assessment. Kluwer Academic Publishers; Boston: 2000. pp. 314–332.
    1. Stephenson J., Bader D. Appletree Press, Inc.; Mankato, MN: 2010. HealthCheques Carbohydrate, Fat and Calorie Guide.
    1. Tudor-Locke C., Craig C.L., Brown W.J. How many steps/day are enough? For adults. Int. J. Behav. Nutr. Phys. Act. 2011;8:79.
    1. Tuomilehto J., Lindstrom J., Eriksson J.G., for the Finnish Diabetes Prevention Study Group Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N. Engl. J. Med. 2001;344:1343–1350.
    1. U.S. Department of Agriculture and U.S. Department of Health and Human Services . 7th ed. Government Printing Office; Washington DC: 2010. Dietary Guidelines for Americans, 2010.
    1. U.S. Department of Health and Human Services National Diabetes Education Program . NIH Publication; Washington, DC: 2006. Small Steps, Big Rewards: Your Game Plan to Prevent Type 2 Diabetes. (No. 06-5334)
    1. Venditti E.M., Wylie-Rosett J., Delahanty L.M., Mele L., Hoskin M.A., Edelstein S.L., for the Diabetes Prevention Program Research Group Short and long-term lifestyle coaching approaches used to address diverse participant barriers to weight loss and physical activity adherence. Int. J. Behav. Nutr. Phys. Act. 2014;11:16.
    1. Weinhold K., Miller C.K., Marrero D.G., Nagaraja H.N., Focht B.C., Gasgon G. Translating diabetes prevention to the worksite: results from a randomized controlled trial. Am. J. Health Promot. 2015 (under review)

Source: PubMed

3
Abonner