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Table 2 Outline of the Walking Away programme (delivered to the Walking Away group and the Walking Away Plus group)

From: PRomotion Of Physical activity through structured Education with differing Levels of ongoing Support for people at high risk of type 2 diabetes (PROPELS): study protocol for a randomized controlled trial

Module:

Main aims:

Example activity:

Theoretical underpinning:

Time weighting

Patient Story

Give participants a chance to share their knowledge and perceptions of prediabetes and highlight any concerns they may want the programme to address.

Participants are asked to share their story, how they were diagnosed with prediabetes and their current knowledge of prediabetes

Common Sense Model [67]

15 % (30 minutes)

Professional story and risk communication

Use simple non-technical language, analogies, visual aids and open questions to provide participants with an overview of healthy glucose metabolism, the aetiology of prediabetes and diabetes, and the risk factors and complications associated with elevated blood glucose levels (cholesterol, blood pressure, cardiovascular risk etc.). Support participants to consider how their individual risk factors (modifiable and non-modifiable) can stack up, identify their own personal risk factors, and identify options to reduce their risk

1) The following model for insulin resistance is used: Glucose moves from the blood into cells to be used as energy via a door with a lock on it. Insulin keys are used to open the lock; insulin resistance occurs when the cell locks get rusty.

Common Sense Model [41], Social Cognitive Theory [68], Dual Process Theory [69]

35 % (60 minutes)

2) Using resources participants are encouraged to share their knowledge of their risk factors for developing T2DM, plot their own personal risk factors and work out which risk factors they can personally alter.

Diet

Give participants an accurate understanding of the link between dietary macro-nutrients and metabolic dysfunction

Participants are asked to group food models into their dominant macro-nutrient groups (i.e. carbohydrate, fat, protein). Fats and oils are divided into saturated, polyunsaturated and monounsaturated categories.

Social Cognitive Theory [68] Dual Process Theory [69]

10 % (20 minutes)

Physical activity

Use simple non-technical language, analogies, visual aids and open questions to help participants: identify how physical activity improves glucose control; understand the current physical activity recommendations and how these relate to steps per day; explore options for incorporating physical activity (primarily walking) into everyday life; identify barriers to exercise; form action plans; encourage participants to use their provided physical activity diaries and pedometers; and set personal step per day goals.

1) Participants are encouraged to share their knowledge of the various exercise recommendations and to work out how each recommendation may affect their health.

Social Cognitive Theory [68]

40 % (70 minutes)

Implementation Intentions [70] Dual Process Theory [69]

2) Participants are provided with a physical activity diary and pedometer and helped to set their first action plan.