Physical activity counselling for individuals living with prediabetes: Evidence-based and practical solution


Exercise is a cornerstone for the treatment and prevention of Type 2 Diabetes (T2D). Despite the effectiveness of regular exercise for decreasing the risk of developing T2D in those with prediabetes, very few community programs exist for this population. To reach the growing number of individuals most at risk for development of T2D, feasible programs specific to prediabetes must be developed. Small Steps for Big Changes is an evidence-based, brief physical activity counselling program designed to be implemented in the community. Initial efficacy of this program was first evaluated in a controlled setting. Over a two-week period, 120 individuals with prediabetes were provided with 70 minutes of counselling targeting goal-setting, self-monitoring, self-efficacy, outcome expectancies and value, rewards and feedback. This brief amount of counselling resulted in significant improvements in self-regulatory efficacy, outcome expectations, and enjoyment post-intervention (p's < .05), and has significantly increased and maintained purposeful bouts of moderate and vigorous exercise 1 year after the program concluded (p's < .05), as assessed by accelerometry. This symposium talk will also discuss recent findings of the implementation of Small Steps for Big Changes in a sample of 60 individuals with T2D. These findings provide support for the utility of very brief, evidence-based counselling to combat the growing problem of diabetes in Canada. While the cost of delivering this counselling is low, dissemination and translation of it requires investment and commitment at the community level. Implications for uptake at the community level for this evidence-based program will be discussed.