A pilot randomized trial of technology-assisted goal setting to improve physical activity among primary care patients with prediabetes
Open accessAbstract
Lifestyle behavior changes can prevent progression of prediabetes to diabetes but providers often are not able to effectively counsel about preventive lifestyle changes. We developed and pilot tested the Avoiding Diabetes Thru Action Plan Targeting (ADAPT) program to enhance primary care providers' counseling about behavior change for patients with prediabetes. Primary care providers in two urban academic practices and their patients with prediabetes were recruited to participate in the ADAPT study, an unblinded randomized pragmatic trial to test the effectiveness of the ADAPT program, including a streamlined electronic medical record-based goal setting tool. Providers were randomized to intervention or control arms; eligible patients whose providers were in the intervention arm received the ADAPT program. Physical activity (the primary outcome) was measured using pedometers, and data were gathered about patients' diet, weight and glycemic control. A total of 54 patients were randomized and analyzed as part of the 6-month ADAPT study (2010-2012, New York, NY). Those in the intervention group showed an increase total daily steps compared to those in the control group (+ 1418 vs - 598, p = 0.007) at 6 months. There was also a trend towards weight loss in the intervention compared to the control group (- 1.0 lbs. vs. 3.0 lbs., p = 0.11), although no change in glycemic control. The ADAPT study is among the first to use standard electronic medical record tools to embed goal setting into realistic primary care workflows and to demonstrate a significant improvement in prediabetes patients' physical activity.
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One study applied PHR and HCP DS; Mann et al reported no change in HbA1c and blood glucose levels after the intervention.
“One study applied PHR and HCP DS in their DHIs. Mann et al [49] reported no change in HbA1c and blood glucose levels after the intervention.”
From Digital Health Interventions to Prevent Type 2 Diabetes Mellitus: Systematic Review (2025) · cites this paper as [49]
The Discussion (page unavailable) explicitly reports a lack of change in A1C, and the Abstract reports no change in glycemic control. The Methods list A1C, but not a separate blood-glucose measurement; they describe EMR tools used by primary care providers rather than a patient health record (PHR). (LLM, conf=0.87)
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Cites
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011 · see citing works
Rosamond, W., Flegal, K., Friday, G., Furie, K., Go, A., Greenlund, K., Haase, N., Ho, M., Howard, V., Kissela, B., et al. (2007) · Circulation · doi:10.1161/circulationaha.106.179918 · Cited by 3,277 · see citing works
Obesity and the Environment: Where Do We Go from Here?
Hill, J. O., Wyatt, H. R., Reed, G. W., & Peters, J. C. (2003) · Science · doi:10.1126/science.1079857 · Cited by 2,180 · see citing works
Goal-setting for behavior change in primary care: An exploration and status report
Bodenheimer, T., & Handley, M. A. (2009) · Patient Education and Counseling · doi:10.1016/j.pec.2009.06.001 · Cited by 286 · see citing works
Physician advice and support for physical activity
Glasgow, R. E., Eakin, E. G., Fisher, E. B., Bacak, S. J., & Brownson, R. C. (2001) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(01)00350-6 · Cited by 253 · see citing works
Goal setting in diabetes self-management: taking the baby steps to success
DeWalt, D. A., Davis, T. C., Wallace, A. S., Seligman, H. K., Bryant-Shilliday, B., Arnold, C. L., Freburger, J., & Schillinger, D. (2009) · Patient Education and Counseling · doi:10.1016/j.pec.2009.03.012 · Cited by 134 · see citing works
Dick, J. J., Nundy, S., Solomon, M. C., Bishop, K. N., Chin, M. H., & Peek, M. E. (2011) · Journal of Diabetes Science and Technology · doi:10.1177/193229681100500534 · Cited by 126 · cited 2× · see citing works
“…electronic medical records (EMR), the internet or text messaging can help improve behavioral management of diabetes (Holbrook et al., 2011; Hunter et al., 2008; Christian et al., 2008; Welch and Shayne, 2006; Jackson et al., 2005; Dick et al., 2011; Franklin et al., 2006; Richardson et al., 2005).”
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Flagged first, then by citations
Research works printed but not linked: 32
- Ammerman A.S. Lindquist C.H. Lohr K.N. Hersey J. The efficacy of behavioral interventions to modify dietary fat and fruit and vegetable intake: a review of the evidence Prev. Med. 35 1 2002 25 41 12079438
- Booth A.O. Nowson C.A. Matters H. Evaluation of an interactive, Internet-based weight loss program: a pilot study Health Educ. Res. 23 3 2008 371 381 18349032
- Brown M.J. Sinclair M. Liddle D. Hill A.J. Madden E. Stockdale J. A systematic review investigating healthy lifestyle interventions incorporating goal setting strategies for preventing excess gestational weight gain PLoS ONE 7 7 2012 e39503 22792178 PMC3390339
- Christian J.G. Bessesen D.H. Byers T.E. Christian K.K. Goldstein M.G. Bock B.C. Clinic-based support to help overweight patients with type 2 diabetes increase physical activity and lose weight Arch. Intern. Med. 168 2 2008 141 146 18227359
- Craig CL, Tudor-Locke C, Bauman A. Twelve-Month Effects of Canada on the Move: A Population-Wide Campaign to Promote Pedometer Use and Walking. vol. 222007:406–413. 16971673
- Danaei G. Finucane M.M. Lu Y. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants Lancet 378 9785 2011 31 40 21705069
- De Greef K. Deforche B. Tudor-Locke C. De Bourdeaudhuij I. A cognitive–behavioural pedometer-based group intervention on physical activity and sedentary behaviour in individuals with type 2 diabetes Health Educ. Res 2010 PMC2936553 20338978
- Diedrich A. Munroe D.J. Romano M. Promoting physical activity for persons with diabetes Diabetes Educ. 0145721709352382 2009 20019197
- Dorough A.E. Winett R.A. Anderson E.S. Davy B.M. Martin E.C. Hedrick V. DASH to wellness: emphasizing self-regulation through E-health in adults with prehypertension Health Psychol. 2012 23181455
- Eakin E.G. Lawler S.P. Vandelanotte C. Owen N. Telephone interventions for physical activity and dietary behavior change: a systematic review Am. J. Prev. Med. 32 5 2007 419 434 17478269
- Franklin V.L. Waller A. Pagliari C. Greene S.A. A randomized controlled trial of Sweet Talk, a text-messaging system to support young people with diabetes Diabet. Med. 23 12 2006 1332 1338 17116184
- Gans K.M. Ross E. Barner C.W. Wylie-Rosett J. McMurray J. Eaton C. REAP and WAVE: new tools to rapidly assess/discuss nutrition with patients J. Nutr. 133 2 2003 556S 562S 12566502
- Gans K.M. Risica P.M. Wylie-Rosett J. Development and evaluation of the nutrition component of the Rapid Eating and Activity Assessment for Patients (REAP): a new tool for primary care providers J. Nutr. Educ. Behav. 38 5 2006 286 292 16966049
- Haire-Joshu D. Klein S. Is primary care practice equipped to deal with obesity?: comment on “preventing weight gain by lifestyle intervention in a general practice setting” Arch. Intern. Med. 171 4 2011 313 315 21357806 PMC3607436
- Holbrook A. Pullenayegum E. Thabane L. Shared electronic vascular risk decision support in primary care: computerization of medical practices for the enhancement of therapeutic effectiveness (COMPETE III) randomized trial Arch. Intern. Med. 171 19 2011 1736 1744 22025430
- Challenges in clinical research http://www.ncbi.nlm.nih.gov/books/NBK50888 2010
- Hunter C.M. Peterson A.L. Alvarez L.M. Weight management using the internet a randomized controlled trial Am. J. Prev. Med. 34 2 2008 119 126 18201641
- Jackson C.L. Batts-Turner M.L. Falb M.D. Yeh H.C. Brancati F.L. Gary T.L. Computer and internet use among urban African Americans with type 2 diabetes J. Urban Health 82 4 2005 575 583 16221917 PMC3456680
- Kushner R.F. Tackling obesity: is primary care up to the challenge? Arch. Intern. Med. 170 2 2010 121 123 20101005
- Lin J.J. Mann D.M. Application of persuasion and health behavior theories for behavior change counseling: design of the ADAPT (avoiding diabetes thru action plan targeting) program Patient Educ. Couns. 88 3 2012 460 466 22770813 PMC3417073
- Locke E. Latham G. A Theory of Goal Setting and Task Performance 1990 Englewood Cliffs, NJ Prentice Hall
- Ma J. Yank V. Xiao L. Translating the diabetes prevention program lifestyle intervention for weight loss into primary care: a randomized trial Arch. Intern. Med. 1-9 2012 PMC3856315 23229846
- Mann D.M. Lin J.J. Increasing efficacy of primary care-based counseling for diabetes prevention: rationale and design of the ADAPT (avoiding diabetes thru action plan targeting) trial Implement. Sci. 7 2012 6 22269066 PMC3274467
- Prochaska J.O. Velicer W.F. The transtheoretical model of health behavior change Am. J. Health Promot. 12 1 1997 38 48 10170434
- Richardson C.R. Brown B.B. Foley S. Dial K.S. Lowery J.C. Feasibility of adding enhanced pedometer feedback to nutritional counseling for weight loss J. Med. Internet Res. 7 5 2005 e56 16403720 PMC1550681
- Shilts M.K. Horowitz M. Townsend M.S. Goal setting as a strategy for dietary and physical activity behavior change: a review of the literature Am. J. Health Promot. 19 2 2004 81 93 15559708
- Spink K.S. Reeder B. Chad K. Wilson K. Nickel D. Examining physician counselling to promote the adoption of physical activity Can. J. Public Health 99 1 2008 26 30 18435386 PMC6976068
- Walker E.A. Caban A. Schechter C.B. Measuring comparative risk perceptions in an urban minority population: the risk perception survey for diabetes Diabetes Educ. 33 1 2007 103 110 17272796
- Welch G. Shayne R. Interactive behavioral technologies and diabetes self-management support: recent research findings from clinical trials Curr. Diab. Rep. 6 2 2006 130 136 16542624
- Weymiller A.J. Montori V.M. Jones L.A. Helping patients with type 2 diabetes mellitus make treatment decisions: statin choice randomized trial Arch. Intern. Med. 167 10 2007 1076 1082 17533211
- Wild S. Roglic G. Green A. Sicree R. King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030 Diabetes Care 27 5 2004 1047 1053 15111519
- Yates T. Davies M. Gorely T. Bull F. Khunti K. Effectiveness of a pragmatic education program designed to promote walking activity in individuals with impaired glucose tolerance Diabetes Care 32 8 2009 1404 1410 19602539 PMC2713638
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Chaudhry, U. A. R., Wahlich, C., Fortescue, R., Cook, D. G., Knightly, R., & Harris, T. (2020) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-01020-8 · Cited by 193 · see citing works
Digital Health Interventions to Prevent Type 2 Diabetes Mellitus: Systematic Review
Duong, T., Olsen, Q., Menon, A., Woods, L., Wang, W., Varnfield, M., Jiang, L., & Sullivan, C. (2025) · Journal of Medical Internet Research · doi:10.2196/67507 · Cited by 14 · see citing works
Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review
Khandoker, F., & Grigsby, T. J. (2025) · Applied Sciences · doi:10.3390/app151910567 · Cited by 2 · see citing works
- Authors
- Mann, D. M., Palmisano, J., & Lin, J. J.
- Affiliations
- Boston University (US)
- Mount Sinai Hospital (US)
- Corresponding author
- Mann, Devin M.
- Venue
- Preventive Medicine Reports
- Publisher
- Elsevier BV
- Published
- 2016-12
- Volume
- 4
- Pages
- 107-112
- ISSN
- 2211-3355 (ISSN-L)
- PMC
- PMC4929067
- OpenAlex
- W2405420353
- Cited by
- 42
- References
- 7
- Citations by year
- 2025: 5 · 2024: 9 · 2023: 3 · 2022: 4 · 2021: 5 · 2020: 10 · 2019: 4 · 2017: 1
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Preventive Medicine Reports (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute for Diabetes, Digestive and Kidney Diseases (5K23DK081665)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- prediabetes, physical activity, goal setting, electronic health records, diabetes prevention, lifestyle modification, pedometers, weight loss, glycemic control
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