Effectiveness of the First step Program delivered by professionals versus peers

• Published in: Journal of physical activity & health Vol. 6; no. 4; p. 456
• Main Authors: Tudor-Locke, Catrine, Lauzon, Nicola, Myers, Anita M, Bell, Rhonda C, Chan, Catherine B, McCargar, Linda, Speechley, Mark, Rodger, N Wilson
• Format: Journal Article
• Language: English
• Published: United States 01-07-2009
• Subjects: Adult; Aged; Blood Pressure; Body Weights and Measures; Diabetes Mellitus, Type 2 - therapy; Exercise; Female; Health Personnel; Health Promotion - organization & administration; Heart Rate; Humans; Male; Middle Aged; Peer Group
• ISSN: 1543-3080
• DOI: 10.1123/jpah.6.4.456

To compare the effectiveness of a theory-based lifestyle physical activity (PA) program delivered to individuals with type 2 diabetes in diabetes education centers by professionals and peers.
Changes over 16 weeks in PA (steps/day) and related variables (weight, waist girth, resting heart rate, systolic and diastolic blood pressures) were compared (RMANOVA) for two groups: 157 participants led by 13 different professionals versus 63 participants led by 5 peer leaders.
Overall, the 81 male and 139 female participants (age = 55.7 +/- 7.3 years, BMI = 35.2 +/- 6.6) showed an incremental change of 4,059 +/- 3,563 steps/day, which translates into an extra 37 minutes of daily walking (P < .001). Statistically significant improvements were also seen in weight, waist girth, and blood pressure (all P < .001) and resting heart rate (P < .05). There were no significant differences in outcomes between professional and peer-led groups.
A theory-based behavior modification program featuring simple feedback and monitoring tools, and with a proven element of flexibility in delivery, can be effective under real-world conditions while addressing inevitable concerns about resource allocation. Program delivery by peer leaders, in particular, could address a potential obstacle to dissemination by helping to alleviate existing high caseload demands on diabetes educators.