688-P: Promoting Long-Term Physical Activity in Prediabetes: The PROPELS RCT

Abstract

Objective: Walking Away from Diabetes (Walking Away) is a low resource 3-hour group-based behavioural intervention designed to promote physical activity through pedometer use in those with prediabetes. This trial aimed to investigate whether Walking Away leads to sustained increases in physical activity when delivered with and without an integrated mHealth intervention compared to control.Methods: Those with a history of prediabetes (HbA1c ≥42 [6.0], <48 [6.5] mmol/mol [%]) were recruited from family practices, England. Participants were randomised to: control (CON), Walking Away (WA) or Walking Away Plus (WA+). CON received an information leaflet, WA the Walking Away programme with annual group-based support, and WA+ the Walking Away programme with an mHealth intervention providing automated individually tailored text messages to prompt pedometer use, goal setting and provide feedback; texts were supported by telephone calls (2 per year). The primary outcome was accelerometer measured ambulatory activity (steps/day) at 48 months. The proportion achieving 150 min/week of moderate to vigorous intensity physical activity (MVPA) were also assessed. Follow-up was conducted at 12 and 48 months.Results: 1366 individuals were randomised (median age = 61 years, BMI = 28.4 kg/m2, ambulatory activity = 6638 steps/day, women = 49%, black and minority ethnicity = 28%). Accelerometer data were available for 1017 (74%) and 993 (73%) individuals at 12 and 48 months, respectively. At 12 months, WA+ increased their ambulatory activity by 547 (97.5% CI, 211, 882) steps/day compared to CON and were 1.61 (97.5% CI 1.05, 2.45) times more likely to achieve 150 min/week of MVPA. However, differences were not sustained at 48 months. There were no differences between WA and CON at 12 or 48 months.Conclusion: Combining a physical activity intervention with text messaging and telephone support resulted in modest, but clinically meaningful, changes in physical activity at 12 months, but changes are not sustained after 48 months.