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Randomized Controlled Trial
. 2025 Jan 16;15(1):ibae076.
doi: 10.1093/tbm/ibae076.

Impact of a community-based lifestyle intervention with initial sedentary reduction or physical activity increasing goals on self-reported health-related quality of life

Chantele E Mitchell-Miland  1   2 , Rachel G Miller  3 , Andrea M Kriska  3 , Ada O Youk  2   4 , Tiffany L Gary-Webb  3 , Susan M Devaraj  5 , Thomas J Songer  3 , Vincent C Arena  4 , Wendy C King  3 , Bonny Rockette-Wagner  3
Affiliations
Randomized Controlled Trial

Impact of a community-based lifestyle intervention with initial sedentary reduction or physical activity increasing goals on self-reported health-related quality of life

Chantele E Mitchell-Miland et al. Transl Behav Med. .

Abstract

Background: In previous efforts, health-related quality of life (HRQoL) improved for individuals at high risk of type 2 diabetes and cardiovascular disease after participation in community-based lifestyle interventions (LI) with a moderate-to-vigorous physical activity (MVPA) movement goal.

Purpose: It is unknown whether HRQoL improves with LI when the primary movement goal is to reduce sedentary behavior. HRQoL changes were examined among adults with overweight and prediabetes and/or metabolic syndrome randomized to a 12-month Diabetes Prevention Program-based Group Lifestyle Balance (DPP-GLB) community LI work with goals of weight-loss and either increasing MVPA (DPP-GLB) or reducing sedentary time (GLB-SED).

Methods: Study participants (N = 269) completed the Euroqol 5 dimension 3 long (EQ5D-3L index and EuroQol Visual Analog Scale (EQVAS)-visual analog scale) at baseline, and 6 and 12 months. Paired t-tests were used to evaluate pre-to-post-intervention changes by arm.

Results: Mean EQVAS improvements for the GLB-SED arm at 6 and 12 months were +5.6 (SE = 1.3; P < .0001) and +4.6 (SE = 1.4; P = .0006), respectively. Similar mean EQVAS improvements were reported for the DPP-GLB arm; +5.9 (SE = 1.2; P < .0001) and +4.9 (SE = 1.2; P = .0001) at 6 and 12 months, respectively. Mean EQ5D index improvements were significant in the GLB-SED arm [6 months: +0.03 (SE = 0.01; P = .004); and 12 months: +0.04 (SE = 0.01; P = .006)], but not in the DPP-GLB arm.

Conclusions: Participation in community LI with a primary movement goal to reduce sedentary behavior improved HRQoL at least as well as traditional LI focused more on MVPA improvement, supporting an alternate intervention strategy for those who can't or won't engage in MVPA as the primary movement goal.

Keywords: EQ5D; Health-related quality of life; group lifestyle balance; lifestyle intervention; physical activity; sedentary behavior.

Plain language summary

Lifestyle intervention (LI) helps adults who are at high risk of developing type 2 diabetes by teaching methods to decrease risk by changing habits (e.g., increasing physical activity). However, reducing sedentary time (the time spent sitting) is another way to reduce risk. Given the known importance of health-related quality of life (HRQoL) to community-dwelling adults and the relationship between lifestyle factors and HRQoL, we wanted to see how participation in LI with varying movement goals and changes in lifestyle factors, impacted individuals’ HRQoL (how they function) over a one-year period. Two-hundred sixty-nine participants were enrolled in the study and either received LI to increase physical activity or to decrease sedentary time. These participants also completed two HRQoL surveys at baseline and 6 and 12 months after intervention. We compared the HRQoL survey responses for each participant before and after they had the LI intervention. We did not do any comparisons between intervention groups. At 6 and 12 months, both groups had improvements in their HRQoL. While there were no between group comparisons, the changes in the sedentary intervention appeared to be larger than those in the physical activity intervention. These findings suggest that HRQoL can be improved with a LI that focuses on physical activity or sedentary behavior and can lead to policy changes that provide a tailored approach to increasing movement.

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