Objective: To compare change in physical activity (PA) and dietary fat intake (DFI) in the SHINE (Support, Health Information, Nutrition and Exercise) Study. SHINE was a randomized, controlled weight loss trial (n=257) of 2 telephone (to increase reach) translations of the Diabetes Prevention Program (DPP) lifestyle change intervention, delivered at 5 diverse healthcare sites.
Methods: Participants (metabolic syndrome, no diabetes) were randomized to the DPP lifestyle change program, participating individually (solo; n=129) or in a group conference call (group; n=128). The 16-session DPP curriculum was delivered in year-1 by trained primary care staff and coaches, with continued contact in year-2. Participants: mean age= 51.8 years, 74.3% female, 85.6% white, 44.1% employed, 36.9% annual income <$30K, mean BMI= 39.3 kg/m2, mean PA = 2428.0 mets/week, mean DFI = 33.5% of total calories. We previously reported that both group and solo arms lost significant weight, but solo participants regained. Here we look at change in PA (International Physical Activity Quest.) and DFI (NCI Fat Screener). Mixed linear models compared mean change from baseline in PA and DFI, within and between arms, at 6, 12 and 24 mos. for this longitudinal dataset.
Results: Compared to baseline, the group arm increased PA at 6, 12 and 24 mos. (71.0, 139.5, 255.0 mets/week), the solo arm only improved at 24 mos. (102.0 mets/week). Compared to baseline, the group arm showed decreased DFI at 6, 12 and 24 mos. (1.4%, 1.4%, 1.4%); the solo arm improved at 6 and 12 mos. (2.6%, 2.9%) but not at 24 mos. There were no differences between arms in means for PA or DFI.
Conclusions: Primary care staff can be trained to deliver a telephonic DPP translation that is effective to achieve significant PA and DFI behavior change. Despite anecdotal concerns that group contact may be less tailored to individuals and thus less effective, we found that group may be more effective than solo contact in achieving activity and diet changes associated with weight loss.
P.M. Trief: Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases. L.M. Delahanty: Consultant; Self; Janssen Pharmaceuticals, Inc., Akcea Therapeutics, Nutrisystem, Inc.. Advisory Panel; Self; Jana Care Inc., Omada Health, Inc.. D.A. Cibula: None. R.S. Weinstock: Research Support; Self; Medtronic MiniMed, Inc., Mylan, Kowa Pharmaceuticals America, Inc., Diasome Pharmaceuticals, Inc., Calibra Medical, Dexcom, Inc., Ultradian Diagnostics LLC., JAEB Center For Health Research, JDRF, National Institute of Diabetes and Digestive and Kidney Diseases.
