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Evaluation of the longitudinal change in health behavior profiles across treatment groups in the TODAY clinical trial
Author(s) -
Kaar Jill L.,
Schmiege Sarah J.,
Drews Kimberly,
Higgins Janine,
WaldersAbramson Natalie,
Isganaitis Elvira,
Willi Steven M.,
Marcus Marsha D.,
Zeitler Philip S.,
Kelsey Megan M.
Publication year - 2020
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12976
Subject(s) - medicine , psychosocial , psychological intervention , multinomial logistic regression , latent class model , intervention (counseling) , logistic regression , behavior change , type 2 diabetes , gerontology , demography , clinical psychology , diabetes mellitus , psychiatry , statistics , mathematics , pathology , machine learning , sociology , computer science , endocrinology
Background Individual health behaviors (ie, eating habits and sedentary lifestyle) are associated with type 2 diabetes (T2D). Health behavior profiles specific to adolescents with T2D have not been described. Objective To identify health behavior profiles in adolescents with T2D and examine how these profiles change over time. Methods Diet (via food frequency questionnaire) and activity behaviors (via 3‐day physical activity recall) examined at baseline, 6 months, and 24 months from participants in the the Treatment Options for T2D in Adolescents and Youth (TODAY) study were used for this analysis. Latent profile analysis identified profiles of health behaviors within three time points, and latent transition probabilities were estimated to examine the change from baseline to 6 months (n = 450) and baseline to 24 months (n = 415). Multinomial logistic regressions were used to examine if the assigned TODAY treatment group (Metformin [Met], Met + Rosiglitazone [Rosi], or Met + Lifestyle) predicted change in health behavior profiles. Results Three profiles emerged: “most sedentary,” “healthy eaters,” and “active and eat most.” At 6 months, 50% of males and 29% of females in the Met + Lifestyle treatment group improved in their health behavior profile. Among males only, the Met + Lifestyle treatment group were more likely to improve their profiles from baseline to 6 months ( P = .01). Conclusions Three health behavior profiles emerged and shifted over time. A high quality, lifestyle intervention had little effect on improving health behavior profiles. Optimizing outcomes in youth with T2D might require more robust and multifaceted interventions beyond family‐level lifestyle, including more extensive psychosocial intervention, novel medication regimen, or bariatric surgery.