Changing Physical Activity Behavior in Type 2 Diabetes

Avery, Leah; Flynn, Darren; van Wersch, Anna; Sniehotta, Falko F.; Trenell, Michael I.

doi:10.2337/dc11-2452

Cited by 340Physical Activity and HealthBehavioral Health and InterventionsDiabetes Management and Education

Changing Physical Activity Behavior in Type 2 Diabetes

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Avery, Leah, Flynn, Darren, van Wersch, Anna, Sniehotta, Falko F., Trenell, Michael I.·2012·Diabetes Care

DOI 10.2337/dc11-2452PMC PMC3507564

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Abstract

OBJECTIVE: Behavioral interventions targeting “free-living” physical activity (PA) and exercise that produce long-term glycemic control in adults with type 2 diabetes are warranted. However, little is known about how clinical teams should support adults with type 2 diabetes to achieve and sustain a physically active lifestyle. RESEARCH DESIGN AND METHODS: We conducted a systematic review of randomized controlled trials (RCTs) (published up to January 2012) to establish the effect of behavioral interventions (compared with usual care) on free-living PA/exercise, HbA1c, and BMI in adults with type 2 diabetes. Study characteristics, methodological quality, practical strategies for increasing PA/exercise (taxonomy of behavior change techniques), and treatment fidelity strategies were captured using a data extraction form. RESULTS: Seventeen RCTs fulfilled the review criteria. Behavioural interventions showed statistically significant increases in objective (standardized mean difference [SMD] 0.45, 95% CI 0.21–0.68) and self-reported PA/exercise (SMD 0.79, 95% CI 0.59–0.98) including clinically significant improvements in HbA1c (weighted mean difference [WMD] –0.32%, 95% CI –0.44% to –0.21%) and BMI (WMD –1.05 kg/m2, 95% CI –1.31 to –0.80). Few studies provided details of treatment fidelity strategies to monitor/improve provider training. Intervention features (e.g., specific behavior change techniques, interventions underpinned by behavior change theories/models, and use of ≥10 behaviour change techniques) moderated effectiveness of behavioral interventions. CONCLUSIONS: Behavioral interventions increased free-living PA/exercise and produced clinically significant improvements in long-term glucose control. Future studies should consider use of theory and multiple behavior change techniques associated with clinically significant improvements in HbA1c, including structured training for care providers on the delivery of behavioural interventions.

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MI has been associated with improvements, but its effect size has only been moderate (e.g., ES for physical activity = 0.19).
“While MI has been associated with improvements, the effect size of this technique has only been moderate (e.g., ES for physical activity = 0.19) [115].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [115]
Multicomponent intervention packages have the highest efficacy for behavioral and glycemic outcomes.
“Multicomponent intervention packages have the highest efficacy for behavioral and glycemic outcomes (300,309,311).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:Standards of Care in Diabetes—2023 (2023) · cites this paper as [311]

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Araki, E., Goto, A., Kondo, T., Noda, M., Noto, H., Origasa, H., Osawa, H., Taguchi, A., Tanizawa, Y., Tobe, K., et al. (2020) · Journal of Diabetes Investigation · doi:10.1111/jdi.13306 · Cited by 346 · see citing works
Behaviour change techniques targeting both diet and physical activity in type 2 diabetes: a systematic review and meta-analysis
Cradock, K. A., ÓLaighin, G., Finucane, F. M., Gainforth, H. L., Quinlan, L. R., & Ginis, K. A. M. (2017) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-016-0436-0 · Cited by 343 · see citing works
“Improvements in HbA1c were also associated with the use of a greater number of BCTs in this review also observed in other studies using HbA1c [7] and weight loss as outcomes [12, 13].”
BackgroundMethodResultInfluential
Effect of lifestyle intervention in patients with type 2 diabetes: A meta-analysis
Chen, L., Pei, J.-H., Kuang, J., Chen, H.-M., Chen, Z., Li, Z.-W., & Yang, H.-Z. (2015) · Metabolism · doi:10.1016/j.metabol.2014.10.018 · Cited by 343 · see citing works
Japanese Clinical Practice Guideline for Diabetes 2016
Haneda, M., Noda, M., Origasa, H., Noto, H., Yabe, D., Fujita, Y., Goto, A., Kondo, T., & Araki, E. (2018) · Diabetology International · doi:10.1007/s13340-018-0345-3 · Cited by 317 · see citing works
How can interventions increase motivation for physical activity? A systematic review and meta-analysis
Knittle, K. P., Nurmi, J., Crutzen, R., Hankonen, N. E., Beattie, M. M., & Dombrowski, S. U. (2018) · Health Psychology Review · doi:10.1080/17437199.2018.1435299 · Cited by 304 · see citing works
5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Eichorst, B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s005 · Cited by 305 · see citing works
5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024
ElSayed, N. A., Aleppo, G., Bannuru, R. R., Beverly, E. A., Bruemmer, D., Collins, B. S., Darville, A. K., Ekhlaspour, L., Hassanein, M. M., Hilliard, M. E., et al. (2023) · Diabetes Care · doi:10.2337/dc24-s005 · Cited by 325 · see citing works
Lifestyle modification in NAFLD/NASH: Facts and figures
Hallsworth, K., & Adams, L. A. (2019) · JHEP Reports · doi:10.1016/j.jhepr.2019.10.008 · Cited by 266 · see citing works
Effectiveness of physical activity interventions in achieving behaviour change maintenance in young and middle aged adults: a systematic review and meta-analysis
Murray, J. M., Brennan, S. F., French, D. P., Patterson, C. C., Kee, F., & Hunter, R. F. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.09.021 · Cited by 229 · see citing works
“Several reviews have defined PA maintenance as occurring when a period has elapsed after the intervention ends (Avery et al., 2012; Fjeldsoe et al., 2011; Gourlan et al., 2011) and our definition may be viewed as relatively lenient.”
BackgroundResult
A systematic review of school-based interventions targeting physical activity and sedentary behaviour among older adolescents
Hynynen, S.-T., van Stralen, M. M., Sniehotta, F. F., Araújo-Soares, V., Hardeman, W., Chinapaw, M. J. M., Vasankari, T., & Hankonen, N. (2016) · International Review of Sport and Exercise Psychology · doi:10.1080/1750984x.2015.1081706 · Cited by 253 · see citing works
“In line with some (Avery, Flynn, van Wersch, Sniehotta, & Trenell, 2012; Hendrie et al., 2012) and in contrast to other reviews (Abraham & Graham Rowe, 2009; Dombrowski et al., 2013), we found that effective PA interventions included more BCTs than non-effective interventions.”
ResultSelf-citation
Physical Activity and Diabetes
Sigal, R. J., Armstrong, M. J., Bacon, S., Boulé, N. G., Dasgupta, K., Kenny, G. P., & Riddell, M. C. (2018) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2017.10.008 · Cited by 258 · see citing works
Heart rate variability in the prediction of mortality: a systematic review and meta-analysis of healthy and patient populations
Jarczok, M. N., Weimer, K., Braun, C., Williams, D. P., Thayer, J. F., Gündel, H. O., & Balint, E. M. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104907 · Cited by 246 · see citing works
Physical activity interventions in children and young people with Type 1 diabetes mellitus: a systematic review with meta‐analysis
Quirk, H., Blake, H., Tennyson, R. L., Randell, T. L., & Glazebrook, C. (2014) · Diabetic Medicine · doi:10.1111/dme.12531 · Cited by 233 · see citing works
“Evidence in other populations, including in those with Type 2 diabetes, suggests that physical activity promotion strategies based on theoretical models of behaviour change are more likely to result in sustained physical activity [11].”
Background
Using a behaviour change techniques taxonomy to identify active ingredients within trials of implementation interventions for diabetes care
Presseau, J., Ivers, N. M., Newham, J. J., Knittle, K. P., Konnyu, K. J., & Grimshaw, J. (2015) · Implementation Science · doi:10.1186/s13012-015-0248-7 · Cited by 216 · see citing works
“Many of the techniques for changing patient behaviour identified in the present study have also been highlighted in a recent broader review of interventions to change patients’ physical activity behaviour in type 2 diabetes, which identified a number of specific BCTs as being associated with a greater change in HbA1c…”
Exosomes as Mediators of the Systemic Adaptations to Endurance Exercise
Safdar, A., & Tarnopolsky, M. A. (2018) · Cold Spring Harbor Perspectives in Medicine · doi:10.1101/cshperspect.a029827 · Cited by 203 · see citing works
“Prospective lifestyle interventions that include endurance exercise have been shown to improve glycemic control and insulin sensitivity in patients with both T2DM and dysglycemic obesity (Avery et al. 2012).”
Background
Defining digital medicine
Elenko, E., Underwood, L., & Zohar, D. (2015) · Nature Biotechnology · doi:10.1038/nbt.3222 · Cited by 191 · see citing works
The Impact of Automated Brief Messages Promoting Lifestyle Changes Delivered Via Mobile Devices to People with Type 2 Diabetes: A Systematic Literature Review and Meta-Analysis of Controlled Trials
Arambepola, C., Ricci‐Cabello, I., Manikavasagam, P., Roberts, N. W., French, D., & Farmer, A. A. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5425 · Cited by 188 · see citing works
“Techniques such as those involving goal-setting and planning how to enact behavior or elicit social support were seldom considered, despite evidence that such techniques are generally effective at increasing physical activity in people with diabetes or obese people [63,64].”
A systematic review of the behaviour change techniques and digital features in technology-driven type 2 diabetes prevention interventions
Van Rhoon, L., Byrne, M., Morrissey, E., Murphy, J., & McSharry, J. (2020) · DIGITAL HEALTH · doi:10.1177/2055207620914427 · Cited by 182 · see citing works
Japanese Clinical Practice Guideline for Diabetes 2016
Haneda, M., Noda, M., Origasa, H., Noto, H., Yabe, D., Fujita, Y., Goto, A., Kondo, T., & Araki, E. (2018) · Journal of Diabetes Investigation · doi:10.1111/jdi.12810 · Cited by 183 · see citing works
Obesity and the relation between joint exposure to ambient air pollutants and incident type 2 diabetes: A cohort study in UK Biobank
Li, X., Wang, M., Song, Y., Ma, H., Zhou, T., Liang, Z., & Qi, L. (2021) · PLoS Medicine · doi:10.1371/journal.pmed.1003767 · Cited by 165 · see citing works
“While several traditional risk factors, such as poor diet [2,3], low physical activity [4,5], and poor sleep behaviors have been related to T2D [6,7], recent evidence suggests that ambient air pollution may also contribute to the development of the disease [8– 10].”
Background
Examining the theory‐effectiveness hypothesis: A systematic review of systematic reviews
Dalgetty, R., Miller, C. B., & Dombrowski, S. U. (2019) · British Journal of Health Psychology · doi:10.1111/bjhp.12356 · Cited by 161 · see citing works
Physiological functions of peroxisome proliferator-activated receptor β
Neels, J. G., & Grimaldi, P. A. (2014) · Physiological Reviews · doi:10.1152/physrev.00027.2013 · Cited by 161 · see citing works
It's LiFe! Mobile and Web-Based Monitoring and Feedback Tool Embedded in Primary Care Increases Physical Activity: A Cluster Randomized Controlled Trial
van der Weegen, S., Verwey, R., Spreeuwenberg, M., Tange, H., van der Weijden, T., & de Witte, L. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4579 · Cited by 154 · see citing works
“…change strategies for the promotion of PA are self-monitoring, providing feedback for behavior, goal setting, providing tools to facilitate behavior, action planning, social support, barrier identification, and providing information on the consequences specific to the individual [10,11,13].”
How can weight‐loss app designers' best engage and support users? A qualitative investigation
Tang, J., Abraham, C., Stamp, E., & Greaves, C. (2015) · British Journal of Health Psychology · doi:10.1111/bjhp.12114 · Cited by 152 · see citing works
“One technique not mentioned by our interviewees, which evidence suggest may be important to weight control was prompting problem solving (Avery, Flynn, van Wersch, Sniehotta, & Trenell, 2012; Greaves et al. , 2011).”
Method
Collaborative care for comorbid depression and diabetes: a systematic review and meta-analysis
Atlantis, E., Fahey, P., & Foster, J. (2014) · BMJ Open · doi:10.1136/bmjopen-2013-004706 · Cited by 179 · see citing works
Which Behavior Change Techniques are Associated with Changes in Physical Activity, Diet and Body Mass Index in People with Recently Diagnosed Diabetes?
Hankonen, N. E., Sutton, S. R., Prevost, A. T., Simmons, R. K., Griffin, S. J., Kinmonth, A. L., & Hardeman, W. (2014) · Annals of Behavioral Medicine · doi:10.1007/s12160-014-9624-9 · Cited by 144 · see citing works
Lifestyle medicine
Kushner, R. F., & Sorensen, K. W. (2013) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/01.med.0000433056.76699.5d · Cited by 141 · see citing works
Impact of accelerometer and pedometer use on physical activity and glycaemic control in people with Type 2 diabetes: a systematic review and meta‐analysis
Baskerville, R., Ricci‐Cabello, I., Roberts, N., & Farmer, A. (2017) · Diabetic Medicine · doi:10.1111/dme.13331 · Cited by 131 · see citing works
Effectiveness of Digital Interventions for Improving Glycemic Control in Persons with Poorly Controlled Type 2 Diabetes: A Systematic Review, Meta-analysis, and Meta-regression Analysis
Kebede, M. M., Zeeb, H., Peters, M., Heise, T. L., & Pischke, C. R. (2018) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2018.0216 · Cited by 131 · see citing works
“19 29 Hence, diabetes-related behavioral and clinical outcomes can be improved through active engagement in e-and m-health interventions.”
Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development
Huffman, J. C., DuBois, C. M., Millstein, R. A., Celano, C. M., & Wexler, D. (2015) · Journal of Diabetes Research · doi:10.1155/2015/428349 · Cited by 127 · see citing works
Sedentary Behavior and Incident Cancer: A Meta-Analysis of Prospective Studies
Shen, D., Mao, W., Liu, T., Lin, Q., Lu, X., Wang, Q., Lin, F., Ekelund, U., & Wijndaele, K. (2014) · PLoS ONE · doi:10.1371/journal.pone.0105709 · Cited by 128 · see citing works
5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2026
Bajaj, M. S., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Early, K. B., ChallaSivaKanaka, S., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc26-s005 · Cited by 178 · see citing works
Accelerometer-derived sedentary and physical activity time in overweight=obese adults with type 2 diabetes: cross-sectional associations with cardiometabolic biomarkers
Healy, G. N., Winkler, E. A. H., Brakenridge, C. L., Reeves, M. M., & Eakin, E. G. (2015) · PLoS ONE · doi:10.1371/journal.pone.0119140 · Cited by 123 · see citing works
“Although successful exercise interventions have significantly improved glycaemic control in adults with this condition [2], increasing MVPA in this population presents challenges, with a meta-analysis showing interventions typically achieve weak or moderate effects [3].”
Background
Effect of ‘activity monitor-based’ counseling on physical activity and health-related outcomes in patients with chronic diseases: A systematic review and meta-analysis
Vaes, A. W., Cheung, A., Atakhorrami, M., Groenen, M. T. J., Amft, O., Franssen, F. M. E., Wouters, E. F. M., & Spruit, M. A. (2013) · Annals of Medicine · doi:10.3109/07853890.2013.810891 · Cited by 119 · see citing works
High-Tech Tools for Exercise Motivation: Use and Role of Technologies Such as the Internet, Mobile Applications, Social Media, and Video Games
Tate, D. F., Lyons, E., & Valle, C. G. (2015) · Diabetes Spectrum · doi:10.2337/diaspect.28.1.45 · Cited by 119 · see citing works
“Systematic reviews and metaanalyses suggest that behavioral interventions are more effective at increasing physical activity levels than standard clinical care in general-population adults and in patients with type 2 diabetes (15).”
Background
Use of Behavioral Change Techniques in Web-Based Self-Management Programs for Type 2 Diabetes Patients: Systematic Review
van Vugt, M., de Wit, M., Cleijne, W., & Snoek, F. J. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2800 · Cited by 112 · see citing works
Effects of a Structured Exercise Program on Physical Activity and Fitness in Colon Cancer Survivors: One Year Feasibility Results from the CHALLENGE Trial
Courneya, K. S., Vardy, J. L., O'Callaghan, C. J., Friedenreich, C. M., Campbell, K. L., Harry Prapavessis, A., Crawford, J., O’Brien, P., Dhillon, H. M., Jonker, D. J., et al. (2016) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-15-1267 · Cited by 114 · see citing works
What do we know about brief interventions for physical activity that could be delivered in primary care consultations? A systematic review of reviews
Lamming, L., Pears, S., Mason, D., Morton, K., Bijker, M., Sutton, S., & Hardeman, W. (2017) · Preventive Medicine · doi:10.1016/j.ypmed.2017.02.017 · Cited by 133 · see citing works
Improvement in Health and Possible Reduction in Disease Activity Using Endurance Exercise in Patients With Established Polymyositis and Dermatomyositis: A Multicenter Randomized Controlled Trial With a 1‐Year Open Extension Followup
Munters, L. A., Dastmalchi, M., Andgren, V., Emilson, C., Bergegård, J., Regardt, M., Johansson, A., Tholander, I. O., Hanna, B., Lidén, M., et al. (2013) · Arthritis Care & Research · doi:10.1002/acr.22068 · Cited by 103 · see citing works
Effects of high-intensity interval training and moderate-intensity continuous training on glycaemic control and skeletal muscle mitochondrial function in db/db mice
Chavanelle, V., Boisseau, N., Otero, Y. F., Combaret, L., Dardevet, D. P., Montaurier, C., Delcros, G., Peltier, S. L., & Sirvent, P. (2017) · Scientific Reports · doi:10.1038/s41598-017-00276-8 · Cited by 103 · see citing works
Insulin Sensitivity Following Exercise Interventions: Systematic Review and Meta-Analysis of Outcomes Among Healthy Adults
Conn, V. S., Koopman, R. J., Ruppar, T. M., Phillips, L. J., Mehr, D. R., & Hafdahl, A. R. (2014) · Journal of Primary Care & Community Health · doi:10.1177/2150131913520328 · Cited by 99 · see citing works
“intervention trials among adults with diabetes or to prevent gestational diabetes.(11-20) Few meta-analyses have addressed diabetes prevention in nonpregnant adults.”
Background
Effectiveness of lifestyle-based weight loss interventions for adults with type 2 diabetes: A systematic review and meta-analysis
Terranova, C. O., Brakenridge, C. L., Lawler, S. P., Eakin, E. G., & Reeves, M. M. (2015) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.12430 · Cited by 94 · see citing works
“29%; a magnitude similar to that observed in physical activity-only interventions in type 2 diabetes [39,40].”
Background
Resistance to the Beneficial Effects of Exercise in Type 2 Diabetes: Are Some Individuals Programmed to Fail?
Stephens, N. A., & Sparks, L. M. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-2545 · Cited by 97 · see citing works
Health behaviour change theories: contributions to an ICF-based behavioural exercise therapy for individuals with chronic diseases
Geidl, W., Semrau, J., & Pfeifer, K. (2014) · Disability and Rehabilitation · doi:10.3109/09638288.2014.891056 · Cited by 97 · see citing works
mHealth app using machine learning to increase physical activity in diabetes and depression: clinical trial protocol for the DIAMANTE Study
Aguilera, A., Figueroa, C. A., Hernandez-Ramos, R., Sarkar, U., Cemballi, A. G., Pathak, L. E., Miramontes, J., Yom‐Tov, E., Chakraborty, B., Yan, X., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-034723 · Cited by 99 · see citing works
Systematic review assessing the effectiveness of dietary intervention on gut microbiota in adults with type 2 diabetes
Houghton, D., Hardy, T., Stewart, C. J., Errington, L., Day, C. P., Trenell, M. I., & Avery, L. (2018) · Diabetologia · doi:10.1007/s00125-018-4632-0 · Cited by 96 · see citing works
“Furthermore, interventions targeting physical activity/exercise have also been shown to improve glucose control [41], body composition and liver fat in humans with fatty liver disease [53] and type 2 diabetes mellitus [54], irrespective of weight loss.”
BackgroundSelf-citation
Diet Behavior Change Techniques in Type 2 Diabetes: A Systematic Review and Meta-analysis
Cradock, K. A., OLaighin, G. M., Finucane, F. M., McKay, R. C., Quinlan, L. R., Ginis, K. A. M., & Gainforth, H. L. (2017) · Diabetes Care · doi:10.2337/dc17-0462 · Cited by 87 · see citing works
“3 mmol/mol) as clinically significant, which follows the precedent set by others (14; 15).”
BackgroundMethod
Effectiveness of HIIE versus MICT in Improving Cardiometabolic Risk Factors in Health and Disease: A Meta-analysis
Maturana, F. M., Martus, P., Zipfel, S., & Niess, A. M. (2020) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002506 · Cited by 87 · see citing works
“Structured exercise training programs have already been shown to improve insulin and glucose metabolism (138,139).”
Background
Optimizing diabetes control in people with type 2 diabetes through nurse-led telecoaching
Odnoletkova, I., Goderis, G., Nobels, F., Fieuws, S., Aertgeerts, B., Annemans, L., & Ramaekers, D. (2016) · Diabetic Medicine · doi:10.1111/dme.13092 · Cited by 78 · see citing works
Strategies to Increase Physical Activity
Tuso, P. J. (2015) · The Permanente Journal · doi:10.7812/tpp/14-242 · Cited by 84 · see citing works
Living Well With Diabetes: 24-Month Outcomes From a Randomized Trial of Telephone-Delivered Weight Loss and Physical Activity Intervention to Improve Glycemic Control
Eakin, E., WINKLER, E. A. H., Dunstan, D. W., Healy, G. N., Owen, N. G., Marshall, A. L., Graves, N., & Reeves, M. M. (2014) · Diabetes Care · doi:10.2337/dc13-2427 · Cited by 83 · see citing works
“Our intervention effect for MVPA is similar to what has been previously reported in type 2 diabetes (34).”
Self-tracking of Physical Activity in People With Type 2 Diabetes: A Randomized Controlled Trial
Kooiman, T. J. M., de Groot, M., Hoogenberg, K., Krijnen, W. P., van der Schans, C. P., & Kooy, A. (2018) · CIN: Computers, Informatics, Nursing · doi:10.1097/cin.0000000000000443 · Cited by 78 · see citing works
Successful behavioural strategies to increase physical activity and improve glucose control in adults with Type 2 diabetes
Avery, L., Flynn, D., Dombrowski, S. U., van Wersch, A., Sniehotta, F. F., & Trenell, M. I. (2015) · Diabetic Medicine · doi:10.1111/dme.12738 · Cited by 77 · see citing works
Self-citation
Physical Activity Counselling during Pulmonary Rehabilitation in Patients with COPD: A Randomised Controlled Trial
Burtin, C., Langer, D., Remoortel, H. V., Demeyer, H., Gosselink, R., Decramer, M., Dobbels, F., Janssens, W., & Troosters, T. (2015) · PLoS ONE · doi:10.1371/journal.pone.0144989 · Cited by 73 · see citing works
“Elements of motivational interviewing have been used to alter physical activity behaviour in various populations other than COPD including patients with cancer, type II diabetes [37], obesity [38], congestive heart failure [39], adults at risk for cardiovascular disease [40, 41] and healthy adults [42, 43].”
Method
Hypogonadal obese men with and without diabetes mellitus type 2 lose weight and show improvement in cardiovascular risk factors when treated with testosterone: An observational study
Haider, A., Saad, F., Doros, G. D., & Gooren, L. J. (2013) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2013.10.005 · Cited by 70 · see citing works
Usefulness of a Positive Psychology-Motivational Interviewing Intervention to Promote Positive Affect and Physical Activity After an Acute Coronary Syndrome
Huffman, J. C., Feig, E. H., Millstein, R. A., Freedman, M., Healy, B. C., Chung, W.-J., Amonoo, H. L., Malloy, L., Slawsby, E., Januzzi, J. L., et al. (2019) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2019.03.023 · Cited by 70 · see citing works
Characterizing Active Ingredients of eHealth Interventions Targeting Persons With Poorly Controlled Type 2 Diabetes Mellitus Using the Behavior Change Techniques Taxonomy: Scoping Review
Kebede, M. M., Liedtke, T. P., Möllers, T., & Pischke, C. R. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7135 · Cited by 69 · see citing works
Can physical activity interventions for adults with type 2 diabetes be translated into practice settings? A systematic review using the RE-AIM framework
Matthews, L., Kirk, A. F., MacMillan, F., & Mutrie, N. (2013) · Translational Behavioral Medicine · doi:10.1007/s13142-013-0235-y · Cited by 67 · see citing works
Optimizing a Positive Psychology Intervention to Promote Health Behaviors After an Acute Coronary Syndrome: The Positive Emotions After Acute Coronary Events III (PEACE-III) Randomized Factorial Trial
Celano, C. M., Albanese, A. M., Millstein, R. A., Mastromauro, C. A., Chung, W.-J., Campbell, K. A., Legler, S. R., Park, E. R., Healy, B. C., Collins, L. M., et al. (2018) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000584 · Cited by 78 · see citing works
The Potential Impact of Displacing Sedentary Time in Adults with Type 2 Diabetes
Falconer, C., Page, A. S., Andrews, R. C., & Cooper, A. R. (2015) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000651 · Cited by 62 · see citing works
“In addition, lifestyle interventions to increase physical activity often have weak effects, with most people failing to achieve increases in MVPA sufficient to confer health benefits (2).”
Background
Integrating smartphone technology, social support and the outdoor physical environment to improve fitness among adults at risk of, or diagnosed with, Type 2 Diabetes: Findings from the ‘eCoFit’ randomized controlled trial
Plotnikoff, R. C., Wilczynska, M., Cohen, K. E., Smith, J. J., & Lubans, D. R. (2017) · Preventive Medicine · doi:10.1016/j.ypmed.2017.08.027 · Cited by 60 · see citing works
“eCoFit is an innovative, lifestyle program which has similar or greater magnitude of effects compared to previous research in this area (8, 9, 34, 36).”
BackgroundResult
Goal-setting in diabetes self-management: A systematic review and meta-analysis examining content and effectiveness of goal-setting interventions
Fredrix, M., McSharry, J., Flannery, C., Dinneen, S. F., & Byrne, M. (2018) · Psychology and Health · doi:10.1080/08870446.2018.1432760 · Cited by 61 · see citing works
“In a set of in-depth analyses, they identified which BCTs were utilised within these interventions and which BCTs may be associated with improvements in average blood glucose levels (measured in glycated haemoglobin level; HbA1c; Avery et al., 2012).”
Background
Implementation strategies to enhance management of heavy alcohol consumption in primary health care: a meta‐analysis
Keurhorst, M. N., van de Glind, I., do Amaral-Sabadini, M. B., Anderson, P., Kaner, E., Newbury‐Birch, D., Braspenning, J. C. C., Wensing, M., Heinen, M. M., & Laurant, M. G. H. (2015) · Addiction · doi:10.1111/add.13088 · Cited by 60 · see citing works
A systematic review of adherence to physical activity interventions in individuals with type 2 diabetes
MacDonald, C. S., Ried‐Larsen, M., Soleimani, J., Alsawas, M., Lieberman, D. E., Ismail, A. S., Serafim, L. P., Yang, T., Prokop, L., Joyner, M., et al. (2021) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3444 · Cited by 57 · see citing works
Changing Physical Activity Behavior in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis
Casey, B., Coote, S. B., Hayes, S., & Gallagher, S. M. (2018) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2017.12.013 · Cited by 58 · see citing works
A Text-Messaging and Pedometer Program to Promote Physical Activity in People at High Risk of Type 2 Diabetes: The Development of the PROPELS Follow-On Support Program
Morton, K., Sutton, S. R., Hardeman, W., Troughton, J., Yates, T., Griffin, S. J., Davies, M. J., Khunti, K. K., & Eborall, H. (2015) · JMIR mhealth and uhealth · doi:10.2196/mhealth.5026 · Cited by 55 · see citing works
“With this in mind, the PROPELS follow-on support program also targeted other determinants of physical activity behavior change via the text message component and employed additional BCTs to achieve the overall intervention objectives (see Multimedia Appendix 1).”
BackgroundInfluential
In Vitro Killing of Schistosomula of Schistosoma Mansoni by BCG and C. Parvum-Activated Macrophages
Mahmoud, A. A. F., Peters, P., Civil, R. H., & Remington, J. S. (1979) · The Journal of Immunology · doi:10.4049/jimmunol.122.5.1655 · Cited by 56 · see citing works
Effect of peer support interventions on cardiovascular disease risk factors in adults with diabetes: a systematic review and meta-analysis
Patil, S. J., Ruppar, T. M., Koopman, R. J., Lindbloom, E. J., Elliott, S. G., Mehr, D. R., & Conn, V. S. (2018) · BMC Public Health · doi:10.1186/s12889-018-5326-8 · Cited by 54 · see citing works
Overcoming barriers to engagement and adherence to a home-based physical activity intervention for patients with heart failure: a qualitative focus group study
Okwose, N. C., O’Brien, N., Charman, S. J., Cassidy, S., Brodie, D. A., Bailey, K. M., MacGowan, G. A., Jakovljević, D. G., & Avery, L. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-036382 · Cited by 51 · see citing works
Self-citation
Targeting Lifestyle Behavior Change in Adults with NAFLD During a 20-min Consultation: Summary of the Dietary and Exercise Literature
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Changing Physical Activity Behavior in Type 2 Diabetes A systematic review and meta-analysis of behavioral interventions
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What Behaviour Change Techniques used in Behavioural Interventions are Associated with Improvements in Physical Activity Behaviour and HbA1c in Adults with Type 2 Diabetes?
Avery, L., Flynn, D., van Wersch, A., Sniehotta, F., & TRENELL, M. (2013) · Newcastle University ePrints (Newcastle Univesity) · doi:10.25405/ncl.34198908
Self-citation

Authors: Avery, L., Flynn, D., van Wersch, A., Sniehotta, F. F., & Trenell, M. I.
Affiliations: Newcastle University (GB)
School of Social Sciences and Law, Teesside University, Middlesbrough, U.K.
Corresponding author: Avery, Leah
ORCID: Avery, Leah
Flynn, Darren
Sniehotta, Falko F.
Trenell, Michael I.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2012-11-14
Volume: 35
Issue: 12
Pages: 2681-2689
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc11-2452
PMC: PMC3507564
OpenAlex: W2104983431
Cited by: 340
References: 55
Citations by year: 2026: 16 · 2025: 16 · 2024: 25 · 2023: 21 · 2022: 14 · 2021: 28 · 2020: 26 · 2019: 22 · 2018: 29 · 2017: 33 · 2016: 29 · 2015: 31 · 2014: 36 · 2013: 12
FWCI: 2.72
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc-nd
creativecommons.org/licenses/by-nc-nd/3.0/ (vor, 3213 d)
Locations: Diabetes Care (publishedVersion, cc-by-nc-nd)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Northumbria Research Link (Northumbria University) (acceptedVersion)
TeesRep (Teesside University) (submittedVersion)
Newcastle University ePrints (Newcastle Univesity)
Funders: National Institute for Health and Care Research (SRF-2011-04-017)
Economic and Social Research Council (ES/G007470/1)
Topics: Health Sciences › Medicine › Physiology › Physical Activity and Health
Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords: type 2 diabetes, physical activity, behavioral interventions, glycemic control, HbA1c, body mass index, behaviour change techniques, intervention fidelity, provider training, free-living physical activity
MeSH terms: Blood Glucose, Diabetes Mellitus, Type 2, Humans, Exercise

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Changing Physical Activity Behavior in Type 2 Diabetes

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