The transition from tTTO to LT-TTO in the EQVT was confusing to participants, whereby some health state valuations around this transition appeared to be arbitrary.

No abstract

This study aimed to describe the influence of social support on participants’ self‐efficacy and motivation to perform physical activity before, during and after the Healthy Eating and Active Living for Diabetes in primary care networks (HEALD) programme.HEALD was a controlled trial of a 24‐week primary care‐based walking programme for people with type 2 diabetes, proven effective in increasing physical activity. Data used in this qualitative sub‐study were derived from semi‐structured interviews with purposefully selected HEALD completers (n = 13) six months after the programme ended. Qualitative data were analysed using content analysis.Prior to HEALD, participants reported feeling a lack of social support for diabetes management and fear of diabetes consequences. During the programme, they reported feeling supported by exercise specialists and peers in general and specifically to do physical activity; they reported weakening social support after HEALD ended. Accordingly, participants reported having self‐efficacy and motivation to increase their physical activity during HEALD, but these did not persist after HEALD ended; many relapsed into former behaviours. Participants recommended a longer programme, with more contacts.Our findings are congruent with Social Cognitive Theory. Participants’ reported self‐efficacy and motivation to adopt physical activity during HEALD were tied to feeling supported by the exercise specialists who led the programme and peers participating in the programme. However, these perceived improvements were compromised when social support was no longer available through HEALD. Periodic contacts with a health care provider post‐programme may promote maintenance of positive behaviour changes following diabetes self‐management programmes. Furthermore, an optimal mode of peer support requires study. Copyright © 2014 John Wiley & Sons, Ltd.

The objective of this study was to determine the association between pedometer-assessed steps and type 2 diabetes risk using the Public Health Agency of Canada-developed 16-item Canadian Diabetes Risk Questionnaire (CANRISK) among a large population-based sample of older adults across Alberta, Canada. To achieve our study objective, adults without type 2 diabetes (N = 689) aged 55 years and older provided demographic data and CANRISK scores through computer-assisted telephone interviews between September and November 2012. Respondents also wore a step pedometer over 3 consecutive days to estimate average daily steps. Logistic regression was used to assess the association between achieving 7500 steps/day and risk of diabetes (low vs. moderate and high). Overall, 41% were male, average age was 63.4 (SD 5.5) years, body mass index was 26.7 (SD 5.0) kg/m, and participants averaged 5671 (SD 3529) steps/day. All respondents indicated they were capable of walking for at least 10 min unassisted. CANRISK scores ranged from 13-60, with 18% in the low-risk category (<21). After adjustment, those not achieving 7500 steps/day (n = 507) were more than twice as likely to belong to the higher risk categories for type 2 diabetes compared with those walking ≥7500 steps/day (n = 182) (73.6% vs. 26.4%; odds ratio: 2.37; 95% confidence interval: 1.58 - 3.57). Among older adults without diabetes, daily steps were strongly and inversely associated with diabetes risk using the CANRISK score. Walking remains an important modifiable risk factor target for type 2 diabetes and achieving at least 7500 steps/day may be a reasonable target for older adults.

This study analyzed patient-described barriers and facilitators related to diabetes management, focusing on how these differ by glycemia and across individual characteristics to facilitate targeted diabetes management strategies. A cross-sectional telephone survey was conducted with adult patients with diabetes in Alberta, Canada, asking two open-ended questions to describe the most helpful and difficult components of their diabetes management. Responses were analyzed using directed content analysis using the Theoretical Domains Framework as a template. The most frequently cited facilitator was care context and information and the most frequently cited barriers were cognitive challenges and structural barriers, with patient-perceived barriers and facilitators varying by individual-level factors.