The effects of a supplemental, theory-based physical activity counseling intervention for adults with type 2 diabetes.

BACKGROUND: Physical activity (PA) is a cornerstone in the management of type 2 diabetes (T2DM). This pilot investigation explores the effects of a standard diabetes education program compared with a supplemental PA intervention on diabetes-related health outcomes. METHODS: Using a prospective 2-armed design, 96 adults with T2DM were randomly assigned to either standard care (diabetes education program; n = 49) or standard care supplemented with an 8-week, individualized-counseling and community-based PA component (n = 47). Measurements were taken at baseline, 3, 6, and 12 months. Primary outcomes were changes in PA (self-report) and HbA1c. Between group changes were compared using analysis of covariance (ANCOVA) and changes over time using repeated-measures ANOVA. RESULTS: In comparison with standard care, the supplemental group demonstrated an increase in PA (Ps < 0.01) and cardiorespiratory fitness (Ps < 0.05) from baseline to all follow-up time-points. HbA1c levels declined (P < .05) from baseline to all time points in the standard care group. Reduction in cholesterol-ratio (P < .01), increase in HDL (P < .05), and reductions in blood pressure, resting heart rate and BMI (approaching statistical significance Ps < 0.10) were also reported for both groups. CONCLUSIONS: PA counseling in addition to standard care is effective for promoting PA behavior change and positive health-related outcomes among individuals with T2DM.

Geographic information systems (GIS) for Health Promotion and Public Health: a review.

The purpose of this literature review is to identify how geographic information system (GIS) applications have been used in health-related research and to critically examine the issues, strengths, and challenges inherent to those approaches from the lenses of health promotion and public health. Through the review process, conducted in 2007, it is evident that health promotion and public health applications of GIS can be generally categorized into four predominant themes: disease surveillance (n = 227), risk analysis (n = 189), health access and planning (n = 138), and community health profiling (n = 115). This review explores how GIS approaches have been used to inform decision making and discusses the extent to which GIS can be applied to address health promotion and public health questions. The contribution of this literature review will be to generate a broader understanding of how GIS-related methodological techniques and tools developed in other disciplines can be meaningfully applied to applications in public health policy, promotion, and practice.

Mechanisms for understanding the facilitators and barriers to capacity building for chronic disease prevention activities: an illustration.

This study explored facilitators and barriers to capacity building for chronic disease prevention (CDP) activities with participants in community-based workshops on environments related to CDP. Three phases of research were conducted. Worksheet analysis (Phase A) indicated that participants (n = 34) identified priority strategies related to the physical environment as a primary focus for CDP, followed by sociocultural, economic, and political environments. Questionnaire completion (Phase B; n = 17) indicated that individuals' capacity was inhibited by a lack of organizational infrastructure (particularly, resources and public and research support). Interviews (Phase C; n = 11) revealed five factors that limited participants' capacity: (a) organizations' lack of competing priorities, (b) priorities secondary to the organizational mandate, (c) disconnect between organizational and government or funder priorities, (d) limited resources, and (e) larger community issues. Implications for research and practice are discussed.

Exploring facilitators and barriers to individual and organizational level capacity building: outcomes of participation in a community priority setting workshop.

This article explores facilitators and barriers to individual and organizational capacity to address priority strategies for community-level chronic disease prevention. Interviews were conducted with a group of participants who previously participated in a community priority-setting workshop held in two Alberta communities. The goal of the workshop was to bring together key community stakeholders to collaboratively identify action strategies for preventing chronic diseases in their communities. While capacity building was not the specific aim of the workshop, it could be considered an unintended byproduct of bringing together community representatives around a specific issue. One purpose of this study was to examine the participants' capacity to take action on the priority strategies identified at the workshop. Eleven one-on-one semi-structured interviews were conducted with workshop participants to examine facilitators and barriers to individual and organizational level capacity building. Findings suggest that there were several barriers identified by participants that limited their capacity to take action on the workshop strategies, specifically: (i) organizations' lack of priorities or competing priorities; (ii) priorities secondary to the organizational mandate; (iii) disconnect between organizational and community priorities; (iv) disconnect between community organization priorities; (v) disconnect between organizations and government/funder priorities; (vi) limited resources (i.e. time, money and personnel); and, (vii) bigger community issues. The primary facilitator of individual capacity to take action or priority strategies was supportive organizations. Recognition of these elements will allow practitioners, organizations, governments/funders, and communities to focus on seeking ways to improve capacity for chronic disease prevention.

The role of self-efficacy on the relationship between the workplace environment and physical activity: a longitudinal mediation analysis.

Cross-sectional studies show that self-efficacy (SE) serves as a partial mediator of the effect that perceptions of workplace environment have on self-reported workplace physical activity (PA). To further explore the role SE plays in the relationship between perceptions of the workplace environment and workplace PA, cross-sectional mediation analyses were performed on adult employees at baseline (n = 897), 6 months (n = 616), and 12 months (n = 612); a longitudinal time-sequence was incorporated into the mediation model; and correlates of residual change version of the mediation were tested. The R (2) ranged from .05 to .08 for the three cross-sectional analyses, .03 for the longitudinal analyses, and from .02 to .03 for the residual analyses. The results from the residual change model analyses supported those of the cross-sectional and longitudinal analyses, suggesting the relationship between perceived workplace environment and PA was partially mediated by SE. Future research should include similar studies with different population groups and in different settings.

Readiness to shop for low-fat foods: a population study.

BACKGROUND: Stages of change are related to dietary fat consumption. Few studies have examined stage occupation within the context of purchasing low-fat foods. OBJECTIVE: To determine the stage-prevalence of individuals for purchasing low-fat foods; identify the frequency of misclassification into action and maintenance (A/M) stages for purchasing for low-fat foods; and explain the demographic and cognitive-variable differences between pseudo (or false positive) A/M and true A/M individuals. DESIGN: Data were collected using a self-administered questionnaire among English-speaking adults (n=1,001) who were randomly sampled by mail. STATISTICAL ANALYSES PERFORMED: Descriptive statistics were used to compare the characteristics of the stage groups. Groups were compared using chi(2) tests and Student t test. RESULTS: Of those who reported being in A/M stages, 32% were misclassified by the staging algorithm and were not true A/M low-fat food purchasers. CONCLUSIONS: Individuals who are in A/M stages for buying low-fat foods still purchase high-fat foods. Stage misclassification may be a persistent problem in studies of dietary change using the Transtheoretical Model.