Helmink Judith H M, Gubbels Jessica S, van Brussel-Visser Femke N, de Vries Nanne K, Kremers Stef P J
Department of Health Promotion, Maastricht University, School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht, MD 6200, the Netherlands.
BMC Res Notes. 2013 May 8;6:190. doi: 10.1186/1756-0500-6-190.
The aim of this study was to explore the predictive value of baseline characteristics in relation to changes in physical activity (PA) and sedentary behaviour among diabetic and pre-diabetic patients participating in a primary care based exercise intervention. We used a descriptive case series among diabetic and pre-diabetic patients (n = 119, 50.8% male, mean age 65.5 (SD = 7.8)). Measurements took place with questionnaires at baseline and two years after the start of the intervention. Predictor variables included demographic factors, Body Mass Index, baseline PA and sitting time, and baseline socio-cognitive profile.
At follow-up, respondents spent more time being physically active than at baseline. For the total group, the average sitting time remained almost unchanged between the two measurements. Further exploration showed that respondents who had relatively high levels of PA at the start of the intervention, increased their total sitting time, while respondents with relatively low levels of PA at the start decreased their sitting time. The socio-cognitive profile did not predict behaviour change. The intervention appeared to be suitable for people with a low-education level, but the results should be interpreted in view of the limitations of the study such as the non-controlled design, self-reported outcomes and selective drop-out of participants.
Interventions for this specific target group may need to put more emphasis on the prevention of increased sitting time. The finding that the socio-cognitive profile did not predict behaviour change may underline the proposition that decisions to initiate and maintain PA behaviour change are to a large extend non-linear events. Acknowledging the possible non-linearity of the relationship between socio-cognitive determinants and behaviour change will help our understanding of this complex and dynamic process.
本研究旨在探讨参与基于初级保健的运动干预的糖尿病和糖尿病前期患者的基线特征与身体活动（PA）和久坐行为变化之间的预测价值。我们对糖尿病和糖尿病前期患者进行了描述性病例系列研究（n = 119，男性占50.8%，平均年龄65.5岁（标准差 = 7.8））。在基线和干预开始两年后通过问卷调查进行测量。预测变量包括人口统计学因素、体重指数、基线PA和久坐时间，以及基线社会认知概况。
在随访时，受访者进行身体活动的时间比基线时更多。对于整个组，两次测量之间的平均久坐时间几乎没有变化。进一步探究表明，在干预开始时PA水平相对较高的受访者，其总久坐时间增加，而在开始时PA水平相对较低的受访者则减少了久坐时间。社会认知概况并未预测行为变化。该干预似乎适用于低教育水平的人群，但鉴于研究的局限性，如非对照设计、自我报告的结果和参与者的选择性退出，应谨慎解读结果。
针对这一特定目标群体的干预措施可能需要更加强调预防久坐时间增加。社会认知概况未预测行为变化这一发现可能强调了这样一个观点，即启动和维持PA行为改变的决定在很大程度上是非线性事件。认识到社会认知决定因素与行为改变之间关系可能存在的非线性，将有助于我们理解这一复杂而动态的过程。
