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J Hum Nutr Diet. 2007 Feb;20(1):27-36.

Assessment of the transtheoretical model as used by dietitians in promoting physical activity in people with type 2 diabetes.

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Beta Cell Unit, Queen Mary's Hospital, Wandsworth Teaching PCT, London, and Division of Psychology, University of Bedfordshire, Luton, UK.



The transtheoretical model of change (TTM) is an approach to behaviour change, which has been successful in increasing physical activity levels. This study examined the application of a TTM approach to increase physical activity in people with type 2 diabetes by a specialist dietitian.


Forty participants were recruited to either an exercise consultation interview (ECI) or a control group. All participants received a physical activity leaflet and those in the ECI group also received a one-to-one interview with a dietitian a week after their routine appointment. Both self-reported physical activity levels and stage of change were measured at baseline and after 6 weeks.


Thirty-four participants (17 in each group) completed the study. Both groups showed an increase in physical activity levels. However, there was a significant difference in change of physical activity levels in the ECI group alone [F(1,32)=15.99;P<or=0.01]. In the ECI group, eight participants increased their stage of change compared with just one in the control group. There was a highly significant difference between the ECI and control group for success rates of stage progression (P=0.007).


A specialist dietitian with motivational interviewing and behavioural change training can successfully deliver a TTM intervention to people with diabetes that results in an increase in physical activity and stage of change. Dietitians with behavioural change skills may wish to include this approach within their practice.

[Indexed for MEDLINE]

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