Abstract
BackgroundMultiple-risk-factor interventions offer a promising means for addressing the complex interactions between lifestyle behaviors, psychosocial factors, and the social environment. This report examines the long-term effects of a multiple-risk-factor intervention.MethodsPostmenopausal women (N = 279) with type 2 diabetes participated in the Mediterranean Lifestyle Program (MLP), a randomized, comprehensive lifestyle intervention study. The intervention targeted healthful eating, physical activity, stress management, smoking cessation, and social support. Outcomes included lifestyle behaviors (i.e., dietary intake, physical activity, stress management, smoking cessation), psychosocial variables (e.g., social support, problem solving, self-efficacy, depression, quality of life), and cost analyses at baseline, and 6, 12, and 24 months.ResultsMLP participants showed significant 12- and 24-month improvements in all targeted lifestyle behaviors with one exception (there were too few smokers to analyze tobacco use effects), and in psychosocial measures of use of supportive resources, problem solving, self-efficacy, and quality of life.ConclusionThe MLP was more effective than usual care over 24 months in producing improvements on behavioral and psychosocial outcomes. Directions for future research include replication with other populations.
Highlights
Multiple-risk-factor interventions offer a promising means for addressing the complex interactions between lifestyle behaviors, psychosocial factors, and the social environment
Given that the ageadjusted prevalence of diabetes for women was less than 3% in the 1980s but reached nearly 5% in 2004 [6], there is an urgent need to investigate interventions designed to enhance lifestyle behaviors and reduce the risks of coronary heart disease (CHD) associated with diabetes
The analysis evaluated the cost of delivering the Mediterranean Lifestyle Program (MLP) compared to the usual care (UC) condition
Summary
Multiple-risk-factor interventions offer a promising means for addressing the complex interactions between lifestyle behaviors, psychosocial factors, and the social environment. Given that the ageadjusted prevalence of diabetes for women was less than 3% in the 1980s but reached nearly 5% in 2004 [6], there is an urgent need to investigate interventions designed to enhance lifestyle behaviors and reduce the risks of CHD associated with diabetes. The evidence suggests that among people with type 2 diabetes, diet [7], physical activity [8,9], stress [10], smoking [11], and social resources [12,13] are key modifiable CHD risk factors. Multiple-risk-factor interventions could be powerful methods for addressing the complex interactions between lifestyle behaviors [14] and the physical and social environment [15,16,17]. Evidence is needed from studies with longer follow-ups (3–5 years) that a consistent and positive factor related to maintenance is multiple rather than single behavioral targets [20]
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