Diabetes Mellitus, Type 2 Clinical Trial
Official title:
Reducing Sedentary Behaviour at St. Joseph's Primary Care Diabetes Support Program; Effect on Blood Glucose Levels in Patients With Type II Diabetes
The study will implement a prospective one-arm feasibility study. After an initial
eligibility screening by the primary care provider during their intake appointment, new
patients will be invited to participate in an acute intervention to reduce sedentary
behaviour during a group appointment at St. Joseph's Primary Care Diabetes Support (SJHC
PCDSP). Scheduled with up to 10 other people, participants will be encouraged to model the
primary care provider and support team as they engage in minimal sedentary behaviour and
replace sitting with standing and light, incidental movements.
An accelerometer-based sensory (ActivPAL4) will be worn and used to measure the patients'
sedentary behaviour and physical activity patterns, including the duration and frequency of
breaks in sedentary time during the appointment. Capillary blood glucose differences will be
assessed at pre- and post-appointment. A series of paper-pencil questionnaires will also
measure self-efficacy, goal intention, and positive and negative affect at both pre- and
post-appointment.
Following pre-screening at their intake appointment, if appropriate for a DIGMA and eligible
to participate, new patients to SJHC PCDSP will be invited to attend a DIGMA scheduled
two-weeks post-intake appointment. Participants will provide their written informed consent
and patient demographic information, assessed by questionnaire, during the first hour of
their appointment. With a trained research assistant, the participant will complete a series
of behavioural measures including: the Godin Leisure-Time Exercise Questionnaire (GLTEQ) and
a modified Sedentary Behaviour Questionnaire (SBQ). Standardized anthropometric measurements,
including waist circumference, weight, height, and capillary blood glucose, of all
participants will also be completed separately in an exam room.
Consistent with social learning theory, the primary care provider and the DIGMA support team
will model, demonstrate, and verbalize aspects of increased confidence to perform the 1-hour
appointment in a standing position and offer a variety of strategies to cope and overcome any
feelings of discomfort. Emphasis will be placed on the strategies the primary care models
uses to break sitting with standing and light, incidental movements. It will be anticipated
that the participant will observe cues and relevant information specific to their behaviour
change and engage in minimal sedentary behaviour.
The frequency of breaks and the duration of breaks taken during the scheduled DIGMA will be
measured using an ActivPAL4 monitor, a wearable device that can measure sitting/lying,
standing, and walking time, sit-to-stand and stand-to-sit transition counts and step counts.
Capillary blood glucose will be measured by the research staff at both pre- and
post-appointment using a glucometer. As patients are not required to restrict their diet
before a standard DIGMA, there will be no restrictions on food and/or drink intake
before/during the morning of, the travel to, and/or during the appointment. Participants will
be asked to self-report the time and what they ate during their last meal in their
demographics questionnaire.
Self-efficacy and positive and negative affect will be self-reported at both pre- and
post-appointment using a scale adapted from the General Self-Efficacy Scale and the Positive
and Negative Affect Schedule (PANAS), respectively. As well, goal intentions of the patients
will be measured using a questionnaire along three dimensions: respondents will refer to a
specific point in time, to the place, and to the degree of behavioural intent that is linked
to the situational context specified by time and place. An example of one of the questions
will be "Over the next week, do you intend to sit less at home?". Subjects will then indicate
using a 5-point Likert scale the degree to which they endorse this statement (e.g., 1 is not
at all to 5 is completely agree).
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