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BMC Public Health
Published in: BMC Public Health 1/2008

Open Access 01-12-2008 | Research article

Participants' perspective on maintaining behaviour change: a qualitative study within the European Diabetes Prevention Study

Authors: Linda Penn, Suzanne M Moffatt, Martin White

Published in: BMC Public Health | Issue 1/2008

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Abstract

Background

The European Diabetes Prevention Study (EDIPS) is an RCT of diet and exercise interventions in people with impaired glucose tolerance. We undertook a qualitative study, nested within the EDIPS in Newcastle-upon-Tyne, UK, aiming to understand the experience of participants who maintained behaviour change, in order to inform future interventions.

Methods

Participants were purposively sampled, according to success criteria for diet and physical activity change maintenance, and invited to attend individual semi-structured interviews. Fifteen participants completed an interview and reflected on their experience over three to five years. We used the Framework method to analyse the transcribed data.

Results

Main themes were identified as factors that help (props) and those that hinder (burdens) behaviour change maintenance at different organisational levels: individual (both physical and psychological), social and environmental. Pre-existing physical conditions (such as arthritis) and social demands (such as caring for an ageing relative) hindered, whereas the benefits of becoming fitter and of having social and professional support helped, participants in maintaining behaviour change. Participants' long term experiences highlighted the salience of the continuous change in their physical, social and environmental conditions over time.

Conclusion

The construct of props and burdens facilitates a holistic view of participants' behaviour. Efforts to encourage behaviour change maintenance should take account of context and the way this changes over time, and should include strategies to address these issues. The experience of participants who maintain behaviour change highlights the challenges for the wider implementation of diabetes prevention strategies.

Trial Registration

(ISRCTN 15670600)
Appendix
Available only for authorised users
Literature
1.
Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P: Framework for design and evaluation of complex interventions to improve health. BMJ. 2000, 321 (7262): 694-696.CrossRefPubMedPubMedCentral
2.
Nutbeam D: Evaluating health promotion - progress problems and solutions. Health Promotion International. 1998, 13 (1): 27 -244.CrossRef
3.
Nutbeam D: The challenge to provide 'evidence' in health promotion. Health Promotion International. 1999, 14 (2): 99-101.CrossRef
4.
Moffatt S, White M, Mackintosh J, Howel D: Using quantitative and qualitative data in health services research - What happens when mixed method findings conflict? [ISRCTN61522618]. BMC Health Services Research. 2006, 6 (pp 10P):
5.
Astrup A: The effect of exercise and diet on glucose intolerance and substrate utilization?. Nestle Nutr Workshop Ser Clin Perform Programme. 2004, 93-103; discussion 103-9.
6.
Costacou T, Mayer-Davis E.J: Nutrition and prevention of type 2 diabetes. Annual Review of Nutrition. 2003, 23: 147-170.CrossRefPubMed
7.
Pedersen BK, Saltin B: Evidence for prescribing exercise as therapy in chronic disease. Scandinavian Journal of Medicine & Science in Sports. 2006, 16 Suppl 1: 3-63.CrossRef
8.
Department of Health: National Service Framework for Diabetes. Edited by: Health D. 2001, TSO
9.
Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM, Diabetes Prevention Program Research G: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002, 346 (6): 393-403.CrossRefPubMed
10.
Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, Hu ZX, Lin J, Xiao JZ, Cao HB, Liu PA, Jiang XG, Jiang YY, Wang JP, Zheng H, Zhang H, Bennett PH, Howard BV: 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 (4): 537-544.CrossRefPubMed
11.
Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M, Finnish Diabetes Prevention Study G: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001, 344 (18): 1343-1350.CrossRefPubMed
12.
Penn Linda, White Martin: Interventions to prevent or delay the onset of type 2 diabetes in people with impaired glucose tolerance. BMJ Health Intelligence, Public Health. 2008
13.
Eriksson J, Lindstrom J, Valle T, Aunola S, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Lauhkonen M, Lehto P, Lehtonen A, Louheranta A, Mannelin M, Martikkala V, Rastas M, Sundvall J, Turpeinen A, Viljanen T, Uusitupa M, Tuomilehto J: Prevention of Type II diabetes in subjects with impaired glucose tolerance: the Diabetes Prevention Study (DPS) in Finland. Study design and 1-year interim report on the feasibility of the lifestyle intervention programme. Diabetologia. 1999, 42 (7): 793-801.CrossRefPubMed
14.
Rollnick S, Mason P, Butler C: Health Behaviour Change. 1999, Edinburgh, Churchill livingstone
15.
Adolfson: Treating obesity: a qualitative evaluation of a lifestyle intervention for weight reduction. Health Education Journal. 2002, 61 (3): 244-258.CrossRef
16.
Frandsen KB, Kristensen JS: Diet and lifestyle in type 2 diabetes: The patient's perspective. Practical Diabetes International. 2002, 19: 77-80.CrossRef
17.
David Taylor, Michael Bury, Natasha Campling, Sarah Carter, Sara Garfied, Jenny Newbould, Rennie T: A Review of the use of the Health Belief Model (HBM), the Theory of Reasoned Action (TRA), the Theory of Planned Behaviour (TPB) and the Trans-Theoretical Model (TTM) to study and predict health related behaviour change. DOH (UK) NICE guidance. Edited by: Health D. 2006, Department of Health
18.
Jepson R, Harris F, MacGillivray S, Kearney N, Rowa-Dewar N: A review of the effectiveness of interventions, approaches and models at individual, community and population level that are aimed at changing health outcomes through changing knowledge attitude and behaviour. DOH (UK) NICE guidance. Edited by: DOH . 2006, DOH NICE guidance (UK)
19.
Wing RR, Hill JO: Successful weight loss maintenance. Annual Review of Nutrition. 2001, 21: 323-341.CrossRefPubMed
20.
Mclean H: Patterns of diet related self-care in diabetes. Social Science and Medicine. 1991, 32 (6): 689-496.CrossRef
21.
Peel E, Parry O, Douglas M, Lawton J: Taking the biscuit? A discursive approach to managing diet in type 2 diabetes. Journal of Health Psychology. 2005, 10 (6): 779-791.CrossRefPubMed
22.
Ritchie J, Lewis J: Qualitative research practice: a guide for social science students and researchers. 2003, London , Sage Publications, xv, 336-
23.
QSR International Pty Ltd: NVivo qualitative data analysis software; Version 7. 2006, PR9 OPA , QSR International Pty Ltd
24.
Silverman D: Doing Qualitative Research : a practical handbook. 2000, London , Sage
25.
Patrick A: Empirical Phenomenology. An Approach for Qualitative Research. Papers in Social Research Methods LSE Methodology Institute. 2004, Qualitative Series No9:
26.
Kelly MP, Charlton BG, Hanlon P: The four levels of health promotion: An integrated approach. Public Health. 1993, 107 (5): 319-326.CrossRefPubMed
27.
Dalgren G, Whitehead M: Policies and strategies to promote social equity in health. 1991 , Stockholm , Institute of Futures Studies
28.
29.
Klem ML, Wing RR, Lang W, McGuire MT, Hill JO: Does weight loss maintenance become easier over time?. Obesity Research. 2000, 8 (6): 438-444.CrossRefPubMed
30.
Noar SM, Zimmerman RS: Health Behavior Theory and cumulative knowledge regarding health behaviors: are we moving in the right direction?. Health Education Research. 2005, 20 (3): 275-290.CrossRefPubMed
31.
Marteau TM, Weinman J: Self-regulation and the behavioural response to DNA risk information: A theoretical analysis and framework for future research. Soc Sci Med. 2006, 62 (6): 1360-1368.CrossRefPubMed
Metadata
Title
Participants' perspective on maintaining behaviour change: a qualitative study within the European Diabetes Prevention Study
Authors
Linda Penn
Suzanne M Moffatt
Martin White
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2008
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-8-235

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