Doctoral Degrees (Exercise, Sport and Lifestyle Medicine)

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Browsing Doctoral Degrees (Exercise, Sport and Lifestyle Medicine) by Author "Fryer, Bradley James"

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    A community-based lifestyle intervention program for adults with type 2 diabetes mellitus in a low socio-economic status community
    (Stellenbosch : Stellenbosch University, 2016-03) Fryer, Bradley James; Terblanche, Elmarie; Stellenbosch University. Faculty of Education. Dept. of Sport Science
    ENGLISH ABSTRACT : The prevalence, and associated burden of type-two diabetes mellitus (T2DM), is rapidly increasing globally, and in South Africa, with men and women of all ages being affected. While there has been an extensive research into the pathophysiological mechanisms, and to some extent, the management of T2DM, healthcare systems are still not able to adequately deal with the increasing number of patients being diagnosed with the disease. Professional- and community-led lifestyle interventions have recently showed the most promise in combating T2DM. There is however, a paucity of data on comprehensive lifestyle interventions in communities of low socio-economic status (SES), where the incidence of T2DM and its related complications is high. The primary aim of this study was to determine the effectiveness of a community-based, 10-week lifestyle intervention on physiological, psychological and health-related outcomes in adults suffering with T2DM in a low SES community. Forty-three participants completed the study (age 59.5 ± 12.2 years, 25 Women; 18 Men), of which 23 made up the experimental group (EXP; BMI: 33.8 ± 7.5; HbA1c: 8.8 ± 2.1) and 20 made up the control group (CON; BMI: 34.4 ± 9.7; HbA1c: 9.4 ± 2.3). The control group completed a pre- and post-testing session, while experimental completed an additional post-testing retention session. The experimental group participated in a 10-week comprehensive lifestyle intervention. A number of anthropometric, cardiovascular and functional measurements were carried out, and questionnaires related to health-related quality of life (HRQoL), social support, dietary habits and lifestyle behaviours, as well as health professional usage were also administered. Following the 10-week comprehensive lifestyle intervention, there was a positive change in the outcome variables measured. There was a statistically significant decrease (p < 0.05) in body fat percentage, diastolic blood pressure and HbA1c, with a statistically significant increase in the total distance walked during the six-minute walk test (6MWT) (p < 0.05). Furthermore, there was a statistically significant improvement (p < 0.05) in all but three of the HRQoL domains. Dietary habits and lifestyle behaviours improved significantly (p < 0.05), with the exception of eating times where there was no change. The frequency at which the participants actively sought professional assistance with the management of their T2DM did not change significantly (p > 0.05). The results from the retention period, obtained 10-weeks after the conclusion of the intervention, suggest that the changes as a result of the program were maintained, however, it is uncertain if those results can be attributed to the use of the post-intervention guide. The findings of this study indicate that a 10-week comprehensive lifestyle intervention is effective in improving physiological, psychological and health-related outcomes in adults with T2DM living in a low SES community. The use of a post-intervention guide as an assistive device to maintain these improvements requires further investigation and revision. Furthermore, this study reveals the opportunity for community-based interventions to assist the primary healthcare sector in the management and prevention of T2DM.