Efficacy of a Multicomponent Physical Activity Intervention for Teachers With or At Risk of Type 2 Diabetes: The Support, Motivation, and Physical Activity Research for Teachers Health Randomized Controlled Trial

Abstract

Background: Type 2 diabetes is a major cause of illness and disability and physical activity reduces these risks. The SMART Health study aim was to compare the efficacy of a multicomponent intervention to promote aerobic physical activity and resistance training in schoolteachers at risk of or diagnosed with type 2 diabetes, with and without a technology-based behavior change package. Methods: We randomized participants (N = 104) into 3 groups: “wait-list” control group, 5 face-to-face visits with a psychologist and exercise specialist (SH group), or 5 face-to-face visits over a 3-month period with a psychologist and exercise specialist, plus a technology-based behavior change package for an additional 6 months (SH+ group). Physical activity was the primary outcome (daily steps measured by pedometers). Systolic and diastolic blood pressure, waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, plasma lipids, self-reported resistance training, anxiety and depression were also assessed at 3 and 9 months (primary time point). Linear mixed models were used to assess the intervention efficacy of SH and SH+ compared with wait-list control. Results: There were no significant group-by-time effects for steps in the SH or SH+ groups compared to the wait-list control group. Self-reported participation in monthly minutes of resistance training significantly increased at 3-month postbaseline in both groups (SH: 136 min, P < .01, d = 0.33 and SH+: 145 min P < .001, d = 0.4) versus the control group. The improvements were maintained for the SH group at 9 months. There was also a meaningful effect (P < .06, d = −0.23) for reducing anxiety for SH group at 9 months. Conclusions: SMART Health was a feasible, multicomponent intervention, which increased self-reported resistance training but no other secondary outcomes.