Resumen de Changing Physical Activity Behavior in Type 2 Diabetes: A systematic review and meta-analysis of behavioral interventions
Leah Avery, Darren Flynn, Anna Van Wersch, Falko F. Sniehotta, Michael I. Trenell
Behavioral interventions targeting "free-living" physical activity (PA) and exercise that produce long-term glycémie control in adults with type 2 diabetes are warranted. However, little is known about how clinical teams should support adults with type 2 diabetes to achieve and sustain a physically active lifestyle. We conducted a systematic review of randomized controlled trials (RCTs) (published up to January 2012) to establish the effect of behavioral interventions (compared with usual care) on free-living ??/exercise, HbAic, and BMI in adults with type 2 diabetes. Study characteristics, methodological quality, practical strategies for increasing ??/exercise (taxonomy of behavior change techniques), and treatment fidelity strategies were captured using a data extraction form. Seventeen RCTs fulfilled the review criteria. Behavioural interventions showed statistically significant increases in objective (standardized mean difference [SMD] 0.45, 95% CI 0.21-0.68) and self-reported ??/exercise (SMD 0.79, 95% CI 0.59-0.98) including clinically significant improvements in HbA^ (weighted mean difference [WMD] -0.32%, 95% CI -0.44% to -0.21%) and BMI (WMD -1.05 kg/nv\ 95% CI -1.31 to -0.80). Few studies provided details of treatment fidelity strategies to monitor/improve provider training. Intervention features (e.g., specific behavior change techniques, interventions underpinned by behavior change theories/ models, and use of a: 10 behaviour change techniques) moderated effectiveness of behavioral interventions. Behavioral interventions increased free-living PA/exercise and produced clinically significant improvements in long-term glucose control. Future studies should consider use of theory and multiple behavior change techniques associated with clinically significant improvements in HbA^sub 1c^, including structured training for care providers on the delivery of behavioural interventions. [PUBLICATION ABSTRACT]
