Social-ecological resources as mediators of two-year diet and physical activity outcomes in type 2 diabetes patients

Abstract

Objective: In behavioral research directed at the treatment of type 2 diabetes, the challenge is to understand how interventions might facilitate long-term lifestyle changes. The Mediterranean Lifestyle Program (MLP) is an intervention for postmenopausal women diagnosed with type 2 diabetes that has shown promising effects on outcomes that include increased physical activity and reduced fat consumption. The present study extended previous findings by evaluating diet-specific and activity-specific social-ecological resources as possible mediators of intervention effects over a 2-year period.

Main outcome measures: Percent calories from saturated fat and caloric expenditure per week in all physical activities were assessed with self-report questionnaires.

Results: The MLP was successful in increasing participants' use of diet-specific and activity-specific family/friend and neighborhood resources. There was some evidence that changes in those resources mediated intervention effects on saturated fat consumption and physical activity outcomes.

Conclusion: The experimental manipulation of mediators and the demonstrated mediational effects provided some support for the conclusion that social-ecological resources can contribute to improvements in healthful lifestyles for women with type 2 diabetes.