Development of a Theory-Based Daily Activity Intervention for Individuals With Type 2 Diabetes

Abstract

PURPOSE This article describes a theory-driven approach to developing a physical activity intervention for sedentary individuals with type 2 diabetes. METHODS Development of the intervention was based on 6 essential elements of program theory: problem definition, critical inputs, mediating processes, expected outcomes, extraneous factors, and implementation issues. Each element was formulated based on available literature and in collaboration with both intended service deliverers (diabetes educators) and recipients (sedentary persons with type 2 diabetes). RESULTS Diabetes education requires a simple physical activity intervention template that is feasible, acceptable, and effective in a variety of settings. Successful programs are individualized, specific, flexible, and based on walking. Pedometers have potential as self-monitoring and feedback tools. The primary expected outcome is an increase in physical activity, specifically walking. Behavior modification and social support are critical to adoption and adherence. CONCLUSIONS Theory-driven interventions specify what works for whom and under what conditions of delivery. The underlying theoryguides the evaluation, refinement, and clinical replication of an intervention. Recruitment, delivery, and follow-up are realworld implementation issues.