Theory-based approach for maintaining resistance training in older adults with prediabetes: adherence, barriers, self-regulation strategies, treatment fidelity, costs
Effectively preventing and treating chronic diseases through health behavior changes often require intensive theory- and evidence-based intervention including long-term maintenance components. We assessed the efficacy of theory-based maintenance approaches varying by dose for persistently performing resistance training (RT) with the hypothesis that a higher-dose social cognitive theory (SCT) approach would produce greater RT adherence than lower-dose Standard. The Resist-Diabetes study first established 2×/week resistance training (RT) in a 3-month supervised intervention in older (50–69 years, N = 170), overweight to obese (BMI 25–39.9 kg/m2) previously inactive adults who fit prediabetes criteria (fasting glucose concentration = 95–125 mg/dl; oral glucose tolerance test 2-h glucose concentration = 140–199 mg/dl or both). After the supervised phase, participants (N = 159) were then randomly assigned to one of two conditions for transition (3 weeks) and then RT alone in community settings for extended contact, maintenance (6 months), and then no contact (6 months). SCT featured continued tailored, interactive personal, and web-based check-ups focused on RT, self-regulation, and a barrier/strategies approach. Standard involved low-dose, generic personal, and web-based check-ups within the same theoretical approach. SCT and Standard both resulted in similar RT, 2×/week adherence during maintenance (74.4 %) and no-contact phases (53.1 %). Cost analysis indicated the Standard intervention for transition and maintenance was inexpensive ($160). Standard can be translated into practice with the potential for continuous contact and persistence in RT beyond the typical program maintenance phase.
KeywordsBehavioral maintenance Resistance training Diabetes Social cognitive theory Health behavior change Treatment fidelity Cost
This study was funded by National Institute of Diabetes, Digestive, and Kidney Diseases, grant R01 DK082383. We wish to acknowledge the dedication and valuable contributions of John Pownall, RN, MPH, Mary Elizabeth Baugh, MS, RD, Kyle Flack, Ph.D., Nabil Boutagy, Ph.D., Daniel Gochenour, BS, Adrianne Clark, MS, RD, Valisa Hedrick, Ph.D., RD., Chad Blake, BS, Rachel Cornet, MS, RD, Soheir Boshra, MD, Joshua Eikenberg, MPH, and the staff of the area’s health clubs who agreed to work with us on this project.
The contractual arrangements with Sheila G. Winett, MS, have been approved by Virginia Polytechnic Institute and State University.
Adherence to ethical standards
The research protocol was reviewed and approved by the Virginia Tech IRB before research was initiated. Review determined that the proposed activities were in compliance with the University’s Federal-wide Assurance, the Belmont Report principles, 45CFR46, and in accordance with the Helsinki Declaration of 1975, as revised in 2000.
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