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Translational Behavioral Medicine
Published in: Translational Behavioral Medicine 4/2017

01-12-2017 | Systematic Reviews

How can clinical practices pragmatically increase physical activity for patients with type 2 diabetes? A systematic review

Authors: Kelsey A. Luoma, MD, Ian M. Leavitt, MS, Joel C. Marrs, PharmD, Andrea L. Nederveld, MD, Judith G. Regensteiner, PhD, Andrea L. Dunn, PhD, Russell E. Glasgow, PhD, Amy G. Huebschmann, MD, MS

Published in: Translational Behavioral Medicine | Issue 4/2017

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Abstract

Although regular physical activity (PA) is a cornerstone of treatment for type 2 diabetes (T2D), most adults with T2D are sedentary. Randomized controlled trials (RCTs) have proven the effectiveness of PA behavioral interventions for adults with T2D but have rarely been conducted in healthcare settings. We sought to identify PA interventions that are effective and practical to implement in clinical practice settings. Our first aim was to use the valid Pragmatic-Explanatory Continuum Indicator Summary 2 (PRECIS-2) tool to assess the potential for future implementation of PA interventions in clinical practice settings. Our second aim was to identify interventions that effectively increased PA and glycemic control among the interventions in the top tertile of PRECIS-2 scores. We searched PubMed MEDLINE from January 1980 through May 2015 for RCTs of behavioral PA interventions coordinated by clinical practices for patients with T2D. Dual investigators assessed pragmatism by PRECIS-2 scores, and study effectiveness was extracted from original RCT publications. The PRECIS-2 scores of the 46 behavioral interventions (n = 13,575 participants) ranged from 3.0 to 4.8, where 5 is the most pragmatic score. In the most pragmatic tertile of interventions (n = 16) by PRECIS-2 scores, 30.8 and 31.3% of interventions improved PA outcomes and hemoglobin A1c, respectively. A minority of published evidence-based PA interventions for adults with T2D were both effective and pragmatic for clinical implementation. These should be tested for dissemination using implementation trial designs.
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Metadata
Title
How can clinical practices pragmatically increase physical activity for patients with type 2 diabetes? A systematic review
Authors
Kelsey A. Luoma, MD
Ian M. Leavitt, MS
Joel C. Marrs, PharmD
Andrea L. Nederveld, MD
Judith G. Regensteiner, PhD
Andrea L. Dunn, PhD
Russell E. Glasgow, PhD
Amy G. Huebschmann, MD, MS
Publication date
01-12-2017
Publisher
Springer US
Published in
Translational Behavioral Medicine / Issue 4/2017
Print ISSN: 1869-6716
Electronic ISSN: 1613-9860
DOI
https://doi.org/10.1007/s13142-017-0502-4

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