Exploring the process when developing a lifestyle intervention in primary care for type 2 XXXX : a longitudinal process evaluation.

@entity1 @entity6
OBJECTIVES: A thorough understanding of the processes involved in lifestyle interventions is needed in order to close the gap between research and daily practice. This study explored the processes involved in the provision of a lifestyle intervention to @entity1 with @entity6 ( @entity6 ) by health care professionals in primary care. STUDY DESIGN: Mixed methods. METHODS: Health care professionals were asked to intensify lifestyle interventions for @entity1 with @entity6 in a routine care setting. Data were collected by serial interviews with health care professionals and @entity1 , recorded consultations, an activity questionnaire and biomedical information. Qualitative data were analysed using a framework analysis with a phenomenological approach. RESULTS: The lifestyle intervention developed by the health care professionals included motivational interviewing, a nutrition and physical activity diary, and a multidisciplinary approach [physiotherapist, dietician, general practitioner and @entity6 practice nurse (DPN)]. @entity1 and health care professionals were positive about the intervention, and @entity1 were more active (P  =  0.027), lost weight (P  =  0.031) and had lower levels of glycated haemoglobin (P  =  0.012). However, qualitative data showed that @entity1 were passive during the consultation, and did not ask questions about ways to improve their lifestyle. DPNs did not use motivational interviewing optimally; provided @entity1 with information that was difficult to understand; and were easily satisfied with the efforts of the @entity1 . CONCLUSIONS: Lifestyle intervention for @entity1 with @entity6 is difficult in routine primary care. DPNs should adapt to the knowledge level of the @entity1 , and @entity1 must be stimulated to take an active role in their treatment. @entity1 and health care professionals should become equal partners in determining mutually agreeable treatment plans and goals.
