Implementing a physical activity consultation service for adults with diabetes: promising results from a 12 month evaluation

Objective: To provide follow-up data on the implementation of an evidence-based physical activity consultation service for adults with diabetes (published Diabetes UK 2013). Methods: A 12month physical activity intervention is being offered to adults with Type 1 or Type 2 diabetes within NHS Grampian. Promotion of the service is provided within primary and secondary care. Patients self-refer. Patients receive an initial 3045min face-to-face consultation, monthly follow-up consultations for 6 months (face-to-face, email or telephone)and further follow-up consultations at 6 and 12 months. Consultations are guided by evidence-based behaviour change strategies. Results: During the initial 18 months, 47 patients enrolled in the service (60.9 10.2 years; body mass index 33.1 6.9; 51.2% female; 83.7% with Type 2 diabetes). A significant increase was observed from baseline to 6months in the number of participants achieving the physical activity recommendations (IPAQ) (21.3% vs 66.7%; p = 0.002). This was maintained from baseline at 12 months (21.3% vs 54.5%;p= 0.012). A significant increase was observed in positive affect (PANAS) from baseline to 12 months (mean difference 6.5, SD 6.1; 95% CI 1.4, 11.6; p = 0.019). Positive but non-significant changes were also observed in perceived levels of anxiety, depression and negative affect. Process evaluation demonstrated high adoption by health professionals. Reasons given for adoption included protocol integrated with current diabetes care, minimal time requirements from health professionals, and delivery by an experienced exercise/health psychologist. Conclusions: Physical activity consultation should be considered as an effective method of supporting people with diabetes and comorbidities to increase physical activity, promote weight loss and improve psychological wellbeing.