Bright 1 bodies: extending the bright bodies family-based intensive lifestyles therapy to adolescents with type 1 diabetes

Garrett Ash, Kevin Joiner, Mary Savoye, Julien Baker, James Gerosa, Emma Kleck, Neha Patel, Matthew Stults-Kolehmainen, Stuart A. Weinzimer, Margaret Grey

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Abstract

BackgroundOver two-thirds of adolescents with type 1 diabetes (T1D) are sedentary. The Bright 1 Bodies Intensive Lifestyles Program aimed to promote their physical activity (PA) by group exercise classes from the Bright Bodies Weight Management Program, combined with T1D self-management education, copingskills discussions, and parent classes. This pilot study aimed to: 1) evaluate intervention feasibility and acceptability; and 2) examine changes in PA, nutrition, BMI, and T1D self-management behaviors.
MethodsBright 1 Bodies offered 12 sessions per week to sedentary adolescents with T1D (n=18; age 13.7 ± 2.3yrs; 67% female; 67% African-American/Latino; A1c 9.5 ± 2.3%; BMI 88 ± 12%’ile). At baseline and 12wk we assessed: a) feasibility by % enrolled of eligible candidates approached and # of sessions attended; b) acceptability by a 28-item exit survey graded on a 5-point Likert scale: c) PA apart from intervention sessions by number and duration of moderate to vigorous bouts (≥10min, ≥3 METs) registered by a hip accelerometer over 7 days’ wear;d) nutrition by # of fruit and vegetable servings (80g) recorded on 3-day food logs; e) glycemic control by HbA1c, mean glucose, glycemic profiles (% readings <70, 70–180, and >180 mg·dL-1), and insulin daily dose; and f) self-managementvariables by # of weekly glucose tests, the Hypoglycemia Fear Survey Worry Subscale (HFS-W), diabetes Self-Care Inventory (SCI), and Quality of Life Diabetes Module (QOL-D). Repeated measures ANCOVA (covariates gender & age, significance p≤0.05) and Becker’s effect size (d≥0.20 small, ≥0.50 moderate, ≥0.80 large) analyzed the data.
ResultsAmong the 105 eligible candidates approached, n=18 enrolled (16%) and attended median 8 of 12 sessions (range 3–12) while 78% of parents (n=14) attended median 6 sessions (range 1–10). Acceptability scores on all subscales were high (program components/strategies X±SD 4.5 ± 0.4, participant comfort 4.3 ± 0.5, instructor-related factors 4.3 ± 0.6). At both baseline and 12wk, PA (2.6 ± 3.4vs4.3 ± 7.1 * 10-min bouts/week, p=0.52, d=0.22) was low, screen time high (3.6 ± 2.8vs4.1 ± 2.9hrs/day, d<0.20), BMI overweight(24.8 ± 3.1vs24.9 ± 3.3kg*m-2, p=0.35, d<0.20), and glycemic control poor (A1c 9.5 ± 2.3vs9.4 ± 2.1%, p=0.72, d<0.20). Self-management behaviors were also unchanged (p>0.05, d<0.20).
ConclusionThe intervention was feasible and acceptable but did not improve poor PA and nutrition among sedentary adolescents with T1D, suggesting this at-risk population needs more intensive interventions.
Original languageEnglish
Article numberB112
Pages (from-to)S281-S281
Number of pages1
JournalAnnals of Behavioral Medicine
Volume52
Issue numberSupplement 1
DOIs
Publication statusPublished - 11 Apr 2018

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Ash, G., Joiner, K., Savoye, M., Baker, J., Gerosa, J., Kleck, E., ... Grey, M. (2018). Bright 1 bodies: extending the bright bodies family-based intensive lifestyles therapy to adolescents with type 1 diabetes. Annals of Behavioral Medicine, 52(Supplement 1), S281-S281. [B112]. https://doi.org/10.1093/abm/kay013