The cardiovascular (CV) consequences of the growing type 2 diabetes (T2D) epidemic pose a major social and economic burden to society. Increasing physical activity is associated with reduced CV morbidity and mortality in people with T2D, but people with T2D are generally sedentary. Thus, increasing physical activity in people with T2D remains a critical CV health priority. CANDIDATE: The candidate is an Assistant Professor in the Division of General Internal Medicine at the University of Colorado School of Medicine. Her prior research has primarily focused on identifying barriers to physical activity for adults with T2D. Receipt of this K23 would provide training in qualitative methods, survey validation, exercise physiology, and behavioral RCT methods. K23 funding would also allow mentored development and validation of a survey to simply assess T2D-specific physical activity barriers and facilitators and to pilot-test a behavioral intervention that targets these barriers ad facilitators. RESEARCH: The K23 research objective is to systematically identify T2D-specific physical activity barriers and facilitators using focus groups, to develop and validate a T2D-specific version of an existing barriers/facilitators survey (Marcus Decisional Balance survey), and to pilot-test an intervention targeting primary care patients' responses to the T2D-specific survey. The rationale is twofold: first, it is important to identify the barriers and facilitators f physical activity behavior to inform intervention strategies; second, the proposed behavioral interventions is tailored to each participant's barriers/facilitators and yet brief enough to be utilized in primary care. Building on the K23 objective, the long-term goal is to improve CV health for people with T2D by developing, testing, and integrating targeted physical activity interventions into primary care practices. ENVIRONMENT: The environment for this project is outstanding, and draws on the senior research mentors' and consultant's expertise in physical activity/exercise in T2D (Dr. Judy Regensteiner), physical activity behavior (Drs. Andrea Dunn and Bess Marcus), qualitative research (Dr. Dunn), survey validation (Drs. Regensteiner, Dunn, and Marcus), exercise physiology (Drs. Regensteiner and Dunn), and clinical trials research (Drs. Regensteiner, Dunn, and Marcus) as well as experience translating physical activity interventions into practice (Drs. Dunn and Marcus). IMPACT: This project will garner preliminary data for a future R01 to test the targeted intervention's effect on physical activity behavior in primary care settings. The proposed research is significant because it focuses on improving CV health by increasing physical activity for a population with disproportionate CV risk (T2D). Additionally, it will address NHBLI Challenge 3.1 by identifying motivational factors related to physical activity - a priority behavioral risk factor for CV disease - in order to inform interventon strategies.
Over 23 million Americans are estimated to have type 2 diabetes and are thus at very high risk of having a heart attack or stroke. Although regular physical activity protects people with type 2 diabetes from heart attacks and strokes, people with type 2 diabetes are not usually very physically active, for reasons that we do not fully understand. This study will first ask adults who have type 2 diabetes to tell us about their pros and cons of physical activity; next, we will develop a survey to simply assess those pros and cons; finally, we will develop and pilot-test a counseling program targeting the pros and cons that each person reported on their survey, so that we can better help them to increase their physical activity and reduce their cardiovascular risks.
