4 techniques most effective for getting patients active, analysis finds

Certain behavior change techniques implemented by clinicians were associated with increased physical activity by patients with type 2 diabetes, a recent analysis of a systematic review found.

The review included 21 behavior change techniques and 6 intervention features, tested on a total of 1,975 patients with type 2 diabetes and compared with changes in the patients' physical activity and HbA1c. Results were published by Diabetic Medicine on April 1.

Four behavior changes were significantly associated with increased levels of physical activity:

• prompt focus on past success (identification of successful behavior changes),
• barrier identification/problem solving (identification of individual barriers and strategies to overcome them),
• use of follow-up prompts (such as reminder postcards or motivational telephone calls), and
• provision of information on where and when to perform the behavior (such as locations and times for physical activity programs locally).

The analysis also found a significant improvement in HbA1c with 2 techniques: information about where and when to be active and prompt review of behavioral goals. Only 1 technique, pedometer use, was negatively associated with change in physical activity.

These data on the effectiveness of specific behavior change techniques can help clinical care teams optimize their consultations with patients with type 2 diabetes and efficiently offer behavior change support, the study authors concluded. Previous research has found varying results from behavior change techniques, which indicates that, even with this new evidence, techniques will need to be tailored to the patient. “Combined, these data suggest that a ‘one size’ [behavioral] intervention may not fit all and that clinical care teams should have an array of [behavior] change techniques at their disposal and be aware of the context in which they may be most effective,” the authors wrote.

Specifically, they noted that pedometers may have been found ineffective because of the older age of their study population (more than half of patients were over 60). Older patients may need more support to use pedometers effectively, the authors said. They called for more research to identify the most effective ways to deliver these behavior change interventions.