Master of Science
BACKGROUND: The virtual delivery of lifestyle medicine programs (e.g., via web-conferencing platforms) can increase program accessibility for adults living with type 2 diabetes (T2D). PURPOSE: To assess the feasibility of virtually delivering a multi-component group-based lifestyle medicine program that uses wearable technologies and exercise prescriptions in an adult population with T2D. METHODS: This was a six-week, single-cohort feasibility study. The virtual lifestyle medicine program included live-video delivery of group education classes, one-on-one exercise counselling phone calls, flash glucose monitors, wearable activity monitors, and exercise prescriptions. Several feasibility outcomes were assessed including recruitment and retention rates, acceptability (e.g., exit survey), and adherence (e.g., group education class attendance). Data are reported descriptively. RESULTS: Ten participants with T2D were recruited (60% female, 50 ± 15 (SD) years, mean A1c 6.7 ± 0.5 %). Recruitment and retention rates were 29% and 80%, respectively. Most participants (89%) were ‘satisfied’/‘very satisfied’ with the program. There were 3.2 ± 2.6 technology ‘issues’ reported per person, mostly related to study data transfer. Participants attended 83% and 93% of group education classes and one-on-one exercise counselling phone calls, respectively. CONCLUSION: The virtual delivery of a multi-component group-based lifestyle medicine program for adults living with T2D is feasible, however, several study protocol and interventions refinements are recommended before conducting a larger trial.
Summary for Lay Audience
To address common barriers to self-management education in populations with type 2 diabetes, effective delivery of virtual group lifestyle medicine programs is needed. This was a six-week, single group study that assessed the feasibility of delivering a virtual group lifestyle medicine program that used wearable glucose monitors and activity monitors (i.e., FitBit Inspire 2™), and provided personalized exercise prescriptions for patients with type 2 diabetes. This study was conducted through a specialized primary care clinic in London, Ontario. Adults (≥18 years) with type 2 diabetes who owned a smartphone, had Internet access, and were medically cleared to exercise, were included. During a two-week baseline and six-week intervention, participants wore wearable glucose monitors and FitBit Inspire 2™’s. Virtual group education classes (via a videoconferencing platform) and one-on-one exercise counselling phone calls (with an exercise specialist) were delivered bi-weekly, on alternating weeks. Virtual group education classes covered content such as low carbohydrate nutrition topics, how to interpret and use glucose data to make nutrition and exercise decisions, why and how to exercise, and learning coping/problem solving skills. Data (n=10 participants) reported an 80% retention rate at follow-up, 3.2 ± 2.6 mean technology issues per person, high participant satisfaction (89%), and intervention adherence rates of 83% and 93% for group and phone call check-in attendance, respectively. Several opportunities for refinement were found to help inform a pilot study. This work may lead to better, more accessible virtual group education for patients with type 2 diabetes and reduce healthcare worker burden.
Hiemstra, Madison S., "Examining the Feasibility of Delivering a Multi-Component Virtual Lifestyle Medicine Program for Adults with Type 2 Diabetes" (2021). Electronic Thesis and Dissertation Repository. 7912.
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Available for download on Wednesday, June 01, 2022