Development and pilot testing of a novel behavioral intervention for adults with type 2 diabetes using intervention mapping

Abstract

Purpose: A healthy diet and consistent physical activity (PA) form the foundation for effective self-management in adults with type 2 diabetes mellitus (T2DM). Behavioral interventions, which target diet and PA, can facilitate effective diabetes self-management practices. Greater clarity regarding the 'active ingredients' incorporated into behavioral interventions is needed to inform the evidence base about effective intervention techniques to advance behavioral theories and to improve clinical practice. The use of intervention mapping (IM) to develop a novel diabetes intervention to increase consumption of low glycemic index (GI) foods and to increase moderate-to-vigorous intensity PA is presented. Methods: Determinants from self-regulation and the Health Action Process Approach theoretical framework formed the foundation of the intervention. The IM taxonomy of behavior change methods and strategies from Hope Therapy (e.g. goal maps) were used to guide techniques for changing selected theoretical determinants of behavior. A pilot study of the intervention among adults with T2DM (n = 12) was conducted using a pre-/post-test design to evaluate intervention components and participant acceptability. Results: Participants attended a mean (±SD) of 8 (±1.4) of the 10 weekly 90-minute, group-based sessions. The magnitude of effect was moderate (d > 0.50) for the change in behavioral intentions, action control, and action and coping planning for engaging in PA and large (d > 0.80) for the change in action self-efficacy and action and coping planning for eating low GI foods postintervention. Conclusions: Greater emphasis on value-based decision-making, the goal mapping process, and successively progressive exercise goals should be included in future versions of the intervention. Based on pilot testing, a larger randomized controlled trial that incorporates these intervention modifications is warranted and the modified intervention has a greater likelihood for success. ARTICLE HISTORY

Early and slow weight loss responders’ perceptions of an adaptive diabetes prevention trial: A qualitative perspective

“…Both intervention groups were encouraged to self-monitor dietary intake and PA during the first 16 sessions. The augmented GLB + curriculum emphasised problem-solving and self-regulatory practices through self-weighing, frequent goal setting, and goal mapping exercises (see below; Miller et al, 2017).…”

Hope‐enhancement interventions: A third wave coalesces

“…Such interventions are often collectively known as “Hope Therapy.” One of the first therapeutic interventions was principally developed by Dr. Jennifer S. Cheavens, 9 a co‐author of the accompanying article by McLouth et al 4 . In many programs, multiple sessions (i.e., high‐dose hope therapy)—sometimes as many as ten—were used to teach practices for selecting goals (which were not only meaningful but also achievable), devise pathways toward goal attainment, and identify sources of agency to drive these behaviors 10 . Given the large investment of time necessary to facilitate such interventions, there was a need to lower participation‐burden.…”

“…In many programs, multiple sessions (i.e., high-dose hope therapy)-sometimes as many as ten-were used to teach practices for selecting goals (which were not only meaningful but also achievable), devise pathways toward goal attainment, and identify sources of agency to drive these behaviors. 10 Given the large investment of time necessary to facilitate such interventions, there was a need to lower participation-burden. For this reason, Feldman and Dreher were among the first to explore whether hope interventions could be modified into a single 90-min session (i.e., low-dose hope therapy).…”