Staff and participant insights of group-based physical activity interventions for Type 2 Diabetes in a clinical practice setting

Introduction: Physical activity is an important component of Type 2 Diabetes management. Group-based physical activity interventions have been shown to be effective. However, translation of research findings into clinical practice settings is challenging. Evaluating the experiences of both staff and participants can provide useful insight in relation to the development of effective service provision.

Methods: Investigation of this issue was undertaken as part of a larger systematic review of studies reporting implementation of physical activity interventions for Type 2 Diabetes in real-world rather than research settings. An extensive search of electronic databases and grey literature was performed to locate potential publications reporting aspects of implementation. Information relating to the views and opinions of staff and patient participation in group-based interventions was subsequently extracted and analysed.

Results: A total of 3237 articles were identified, of which 50 relevant full text articles were independently reviewed. Twelve articles were found to report aspects of implementation of physical activity interventions in real world settings, of which 4 reported insight from staff and participants via the use of focus groups, interviews and questionnaires. The main findings were: 1) Participants: the opportunity to share stories and ideas with peers was a common theme, in addition to feelings of ‘not being alone’. Participants reported the group environment had a motivational influence towards adhering to their goals and welcomed the presence of the same member of staff delivering the interventions. 2) Staff: staff delivering the group sessions reported that participants responded to incentives (e.g. pedometers) and suggested the use of more hands-on practical activities. They also found the weekly overview content of sessions repetitive; however, this was not reflected in the participant view, as they welcomed the review from previous sessions to consolidate their knowledge. Success of the group intervention was perceived in their ability to provide participants with a sense of ownership in relation to their tasks and goals. Staff also reported that successful delivery was attributed to their ability to maintain group control, maintain a current knowledge of diabetes, and present an outgoing approachable personality to facilitate question and answer sessions.

Discussion: Participants and staff report group-based physical activity interventions play a positive role in physical activity behavior change, predominantly through peer-focused motivation and support. Clinical managers should facilitate the delivery of group-based interventions by providing ongoing support and training of skilled staff, the use of more hands-on activities, and continuity in staff delivery.