Abstract
Background: Losing excess body weight and preventing weight regain by changing lifestyle is a challenging but promising task to prevent the incidence of type-2 diabetes. To be successful, it is necessary to use evidence-based and theory-driven interventions, which also contribute to the science of behavior modification by providing a deeper understanding of successful intervention components.Objective: To develop a physical activity and dietary behavior modification intervention toolbox (PREMIT) that fulfills current requirements of being theory-driven and evidence-based, comprehensively described and feasible to evaluate. PREMIT is part of an intervention trial, which aims to prevent the onset of type-2 diabetes in pre-diabetics in eight clinical centers across the world by guiding them in changing their physical activity and dietary behavior through a group counseling approach.Methods: The program development took five progressive steps, in line with the Public Health Action Cycle: (1) Summing-up the intervention goal(s), target group and the setting, (2) uncovering the generative psychological mechanisms, (3) identifying behavior change techniques and tools, (4) preparing for evaluation and (5) implementing the intervention and assuring quality.Results: PREMIT is based on a trans-theoretical approach referring to valid behavior modification theories, models and approaches. A major “product” of PREMIT is a matrix, constructed for use by onsite-instructors. The matrix includes objectives, tasks and activities ordered by periods. PREMIT is constructed to help instructors guide participants' behavior change. To ensure high fidelity and adherence of program-implementation across the eight intervention centers standardized operational procedures were defined and “train-the-trainer” workshops were held. In summary PREMIT is a theory-driven, evidence-based program carefully developed to change physical activity and dietary behaviors in pre-diabetic people.
Highlights
The incidence of Type 1 or Type 2 Diabetes Mellitus (T2D) is increasing worldwide (NCD RisC, 2016a)
1In the meantime, the taxonomy has been extended (Michie et al, 2013), we developed the PREview behavior Modification Intervention Toolbox (PREMIT) intervention between October 2012 and March 2013, where the CALO-RE taxonomy was already available
PREMIT is based on five closely related, progressive steps. These steps are driven by theoretical knowledge, based on empirical evidence and adaptable to each center’s local context of the multicenter randomized controlled trial in PREVIEW: the addressees, the intervention objective and the treatment conditions
Summary
Losing excess body weight and preventing weight regain by changing lifestyle is a challenging but promising task to prevent the incidence of type-2 diabetes. It is necessary to use evidence-based and theory-driven interventions, which contribute to the science of behavior modification by providing a deeper understanding of successful intervention components
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