BACKGROUND: The escalating global prevalence of type 2 diabetes and prediabetes presents a major public health challenge. Physical activity plays a critical role in managing (pre)diabetes; however, adherence to physical activity recommendations remains low. The ENERGISED trial was designed to address these challenges by integrating mHealth tools into the routine practice of general practitioners, aiming for a significant, scalable impact in (pre)diabetes patient care through increased physical activity and reduced sedentary behaviour. METHODS: The mHealth intervention for the ENERGISED trial was developed according to the mHealth development and evaluation framework, which includes the active participation of (pre)diabetes patients. This iterative process encompasses four sequential phases: (a) conceptualisation to identify key aspects of the intervention; (b) formative research including two focus groups with (pre)diabetes patients (n = 14) to tailor the intervention to the needs and preferences of the target population; (c) pre-testing using think-aloud patient interviews (n = 7) to optimise the intervention components; and (d) piloting (n = 10) to refine the intervention to its final form. RESULTS: The final intervention comprises six types of text messages, each embodying different behaviour change techniques. Some of the messages, such as those providing interim reviews of the patients' weekly step goal or feedback on their weekly performance, are delivered at fixed times of the week. Others are triggered just in time by specific physical behaviour events as detected by the Fitbit activity tracker: for example, prompts to increase walking pace are triggered after 5 min of continuous walking; and prompts to interrupt sitting following 30 min of uninterrupted sitting. For patients without a smartphone or reliable internet connection, the intervention is adapted to ensure inclusivity. Patients receive on average three to six messages per week for 12 months. During the first six months, the text messaging is supplemented with monthly phone counselling to enable personalisation of the intervention, assistance with technical issues, and enhancement of adherence. CONCLUSIONS: The participatory development of the ENERGISED mHealth intervention, incorporating just-in-time prompts, has the potential to significantly enhance the capacity of general practitioners for personalised behavioural counselling on physical activity in (pre)diabetes patients, with implications for broader applications in primary care.
BACKGROUND: The growing number of patients with type 2 diabetes and prediabetes is a major public health concern. Physical activity is a cornerstone of diabetes management and may prevent its onset in prediabetes patients. Despite this, many patients with (pre)diabetes remain physically inactive. Primary care physicians are well-situated to deliver interventions to increase their patients' physical activity levels. However, effective and sustainable physical activity interventions for (pre)diabetes patients that can be translated into routine primary care are lacking. METHODS: We describe the rationale and protocol for a 12-month pragmatic, multicentre, randomised, controlled trial assessing the effectiveness of an mHealth intervention delivered in general practice to increase physical activity and reduce sedentary behaviour of patients with prediabetes and type 2 diabetes (ENERGISED). Twenty-one general practices will recruit 340 patients with (pre)diabetes during routine health check-ups. Patients allocated to the active control arm will receive a Fitbit activity tracker to self-monitor their daily steps and try to achieve the recommended step goal. Patients allocated to the intervention arm will additionally receive the mHealth intervention, including the delivery of several text messages per week, with some of them delivered just in time, based on data continuously collected by the Fitbit tracker. The trial consists of two phases, each lasting six months: the lead-in phase, when the mHealth intervention will be supported with human phone counselling, and the maintenance phase, when the intervention will be fully automated. The primary outcome, average ambulatory activity (steps/day) measured by a wrist-worn accelerometer, will be assessed at the end of the maintenance phase at 12 months. DISCUSSION: The trial has several strengths, such as the choice of active control to isolate the net effect of the intervention beyond simple self-monitoring with an activity tracker, broad eligibility criteria allowing for the inclusion of patients without a smartphone, procedures to minimise selection bias, and involvement of a relatively large number of general practices. These design choices contribute to the trial's pragmatic character and ensure that the intervention, if effective, can be translated into routine primary care practice, allowing important public health benefits. TRIAL REGISTRATION: ClinicalTrials.gov (NCT05351359, 28/04/2022).
- MeSH
- cvičení MeSH
- diabetes mellitus 2. typu * prevence a kontrola MeSH
- lidé MeSH
- multicentrické studie jako téma MeSH
- pragmatické klinické studie jako téma MeSH
- praktické lékařství * MeSH
- prediabetes * terapie MeSH
- randomizované kontrolované studie jako téma MeSH
- sedavý životní styl MeSH
- telemedicína * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- protokol klinické studie MeSH
V článku jsou prezentovány výsledky studie problému odchodu talentované mládeže ze sportu. Tento často se vyskytující jev ve sportovní praxi je dáván do souvislosti s výskytem demotivačních okolností, jejichž povaha byla touto pilotní studií zjišťována. Východiskem byla, ve sportu a sportovní psychologii obecně akceptovaná, teorie sebe determinace a její sub teorie základních potřeb a následně také teorie výkonové motivace operující s existencí dvou výkonových potřeb osobnosti, a to potřebou úspěšného výkonu a potřebou vyhnutí se neúspěchu. Studie vycházela z předpokladu, že při nedodržení zákonitostí pro vytvoření vnitřní motivace ve vztahu ke sportu a při neadekvátním navýšení demotivačních faktorů dojde k opuštění sportovního prostředí, konkrétně v období adolescence, tedy před dosažením nejvyšší vrcholové úrovně. Pro zjištění motivačních a demotivačních faktorů vedoucích ke změně životního stylu u adolescentů jsme využili postupů kvalitativního výzkumu, konkrétně interpretativní fenomenologické analýzy a vícepřípadové studie. Pilotní studie proběhla na čtyřech vrcholových sportovcích, dvou chlapcích a dvou dívkách, kteří nedávno ukončili či aktuálně zvažovali ukončení aktivní závodní kariéry. Sportovci nejčastěji identifikují jako faktory, které vedly k opuštění sportovního prostředí: profil trenéra a jeho metodiku/charakteristiku tréninku; časovou náročnost; nemožnost sladit požadavky sportu s požadavky školy/zaměstnání. Možný praktický důsledek této práce je doporučení přiblížit vztah mezi výzkumnými pracovníky a pracovníky v dané praxi - trenéry. Zejména z důvodu důležitosti zpětné vazby z provedených šetření a následných závěrů. Pouze tímto způsobem si mohou trenéři, federace a vzdělávací systém trenérů uvědomit motivační faktory, které vedou k odchodu talentovaných sportovců.
This article presents the results of a study about problem of drop out talented youth from sport. This often occurring phenomen in sports is related to the occurrence of demotivational circumstances, the nature of which was identified by this pilot study. The starting point was the self-determination theory, basic needs sub-theory, which are generally accepted in sport and sport psychology, and the resulting achievement motivation operating with the existence of two personality performance needs, with motive to approach success and motive to avoid failure. The study was based on the assumption that if the rules for intrinsic motivation were not sustained in relation to sport and with inadequate increase of demotivational factors it leads to the case of athletes abandoning the sport field, especially in the adolescence period, before reaching the highest peak level. To identify the motivational and demotivational factors leading to the change of adolescent ́s lifestyle, we used the qualitative methods of research, namely interpretative phenomenological analysis and multiple case study. A pilot study was conducted on four top athletes, two boys and two girls who recently completed or were currently considering finishing an active racing career. Athletes most often identify as factors that have led to drop out from sport: the trainer’s profile and his / her training methodology / characteristics; too much time consumig; the impossibility of reconciling the requirements of sport with school / job requirements. A possible practical consequence of this work is the recommendation to bring closer the relationship between researchers and trainees in the practice. Especially because of the importance of feedback from the investigations carried out and the subsequent conclusions. Only in this way can coaches, federations, and education system for coaches become aware of the motivation factors that lead to the drop out of talented athletes.
- MeSH
- duševní vyhoření psychologie MeSH
- interview psychologický MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- motivace * MeSH
- osobní autonomie MeSH
- sport pro děti a mládež * psychologie MeSH
- sportovci psychologie MeSH
- sportovní výkon psychologie MeSH
- týmové sporty MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- klinická studie MeSH
