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Table 3 Outline plan of the TRIMS education programme

From: The Reversal Intervention for Metabolic Syndrome (TRIMS) study: rationale, design, and baseline data

PART 1 - First week Overview of the main aims
and activities
Theory
A: Introduction and Housekeeping (5 minutes) To inform participants of the aims of the course, main topics to be covered, and the style of delivery  
B: The Patient Story (20 minutes)
1) Names
2) How did you find out you had metabolic syndrome
3) What do you think it is? Causes?
4) What will it mean for my health? Treatments?
5) Have you a question?
To elicit an individual's experiences, perceptions and health beliefs
Participants are encouraged to share their experiences and beliefs with the rest of the group, and identify any questions they have
Common sense model
C: Metabolic Syndrome and Insulin Resistance
1) Understanding metabolic syndrome (55 minutes)
• Energy from food - food groups
• Healthy metabolism - energy used/stored
• Abdominal obesity and insulin resistance
• Cholesterol
• Blood pressure
2) How does metabolic syndrome affect me? (40 minutes)
• Understanding your personal results
• Causes
• Reversing metabolic syndrome and reducing the risk of T2DM and CVD
To help participants understand what metabolic syndrome is, possible causes, what it means to their health, and possible ways to reduce their future health risk
Participants are helped to work through what is happening in the body with metabolic syndrome, complete their own personal health profile, and consider how they were identified as having metabolic syndrome
Common sense model
Dual process theory
D: Physical Activity (40 minutes)
1) Benefits
2) Recommendations
3) Measuring activity
4) Barriers and facilitators
To facilitate exploration of the recommendations and benefits of physical activity, and possible barriers
Participants are:
Encouraged to consider ways to increase their activity levels (including their own personal activity targets)and how this could reduce future health risk
Shown and discuss how they can use a pedometer and logbook as a motivational tool and encouraged to go away and use them before their next session
Common sense model
Dual process theory
Social cognitive (learning) theory
E: How Am I Doing Participants are encouraged to reflect on the main messages so far and start to think about possible lifestyle changes Social cognitive (learning) theory
PART 2- Second week   
F: Reflections (5 minutes) Participants are encouraged to reflect on issues that have come up and share these with the group Social cognitive (learning) theory
G: Weight management and Food Choices (1) (35 minutes)
1) Factors influencing food choices
2) Monitoring weight/shape
3) Energy balance
4) Losing weight/reducing waist size
5) Food messages
• Fat, alcohol, fruit and vegetables
To help participants explore factors involved in weight management, and consider food choices.
Participants are:
Encouraged to consider practical ways to lose weight/reduce waist size
Helped to work through what factors can cause changes in weight and which foods are higher sources of calories
Shown and discuss how they could use a food diary to record what they eat and drink and identify possible changes they could make.
Common sense model
Dual process theory
Social cognitive (learning) theory
H: Food Choices (2) (75 minutes)
1) Types of fats
2) Omega-3
3) Fibre
4) Salt
5) Making healthier food choices
To facilitate exploration of the recommendations and benefits of making healthier food choices, and how these relate to metabolic syndrome and individual risk factors
Participants are encouraged to consider ways to make healthier food choices (including reading food labels) and how this could reduce future health risk
Common sense model
Dual process theory
Social cognitive (learning) theory
I: Metabolic Syndrome Self-Management Plan (40 minutes)
1) Additional risk factors - smoking, depression
2) Behaviour change
3) Identifying personal risk factors & completing an action plan
To help participants to identify a behavioural goal they can aim for to improve their risk profile/reverse metabolic syndrome, and make a realistic plan of action for this behaviour change
Participants are helped to:
Identify things they want to change based on their personal health profile,
Explore possible options utilising information from previous sessions
Identify personal barriers
Develop their own personal action plan
Social cognitive (learning) theory
J: Questions and Future Care (10 minutes) To ensure that all questions previously raised by participants have been answered fully, and that they know how to access ongoing care and support Common sense model
  1. Throughout the sessions a combination of open questions, analogies, visual aids, games, activities and a personal handbook are used by the educators to assist participants learning. Each week included a 15 minute break.
  2. References: Common sense model [26]; Dual process theory [25]; Social cognitive (learning) theory [24]