Objective: The aim of this study was to evaluate the stages of change toward healthier behavior by telephone-delivery intervention in prediabetic individuals.
Research Design and Methods: A total of 2607 participants aged 20-65 years with impaired fasting glucose were randomized to a one-year telephone-intervention intervention arm (n=1240) or a self-directed control arm with weighing scale and pedometer (n=1367). Stages of change were assessed using a self-administered questionnaire.
Results: At the baseline, 5.9% were in the precontemplation stage, 50.6% were in the contemplation stage, and 25.5% were in the preparation stage in the change to healthy eating. At the baseline, 9.4% were in the precontemplation stage, 50.2% were in the contemplation stage, and 12.0% were in the preparation stage in the change toward adopting exercise habits. For participants who were in the precontemplation stage, the proportions of those progressing to the action/maintenance stage for a healthy eating after 1-year intervention and at the end of the trial were increased (17.5 and 16.1-percentage-point increase, respectively), but there was small increase for exercise habits (5.4 and 2.7-percentage-point increase, respectively). For participants who were in the precontenplation stage, the odds of progressing to the action/maintenance stage for the intervention vs. control arm for healthy eating after 1-year intervention and at the end of the trial were 3.07 (95% CI=1.23, 8.13) and 2.21 (95% CI=1.04, 4.67), respectively. The corresponding odds for excise habits were 1.59 (95% CI=0.70, 3.61) and 1.27 (95% CI=0.55, 2.91). The hazard ratio for the development of diabetes on receiving the intervention in the precontenplation stage of healthy eating at the baseline was 0.51.
Conclusions: The intervention advanced the stages of changes toward healthy eating and might be effective for preventing diabetes even in the precontemplation stage.
N. Sakane: Research Support; Spouse/Partner; Pwc. S. Nirengi: None. K. Takahashi: None. A. Suganuma: None. K. Okazaki: Advisory Panel; Self; Eli Lilly and Company. Research Support; Self; Taisho Pharmaceutical Co., Ltd.. Speaker's Bureau; Self; Ono Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk A/S, Astellas Pharma US, Inc., Takeda Development Center Asia, Pte. Ltd., Terumo Medical Corporation, MSD K.K., Sanwa Kagaku Kenkyusho Co., Ltd.. Other Relationship; Self; Aichi prefecture government and Nagoya city government. K. Izumi: None. M. Noda: None. H. Kuzuya: None.