Modifying an evidence-based lifestyle programme for individuals with traumatic brain injury

ABSTRACT

Objective: Individuals with traumatic brain injury (TBI) are at a risk of obesity-related chronic diseases; yet, no evidence-based strategies exist to support weight management in this population. The purpose of this study was to use participatory action research to modify the Diabetes Prevention Program Group Lifestyle Balance (DPP-GLB) programme for overweight/obese people with TBI. The DPP-GLB programme provides education and self-management skills for individuals to reach their lifestyle goals through healthy eating and physical activity. Methods: A committee of 10 stakeholders including clinicians, patients and caregivers reviewed and modified the DPP-GLB for overweight/obese individuals with TBI. Stakeholders suggested modifications to the content, layout, format, language, behaviour-changing strategies and delivery approaches. The group also provided input on research applications of the modified DPP-GLB including recruitment strategies, study design and patient-centred outcome measures. Results: Strategies for successful implementation in this population focused on determining (1) eligibility criteria for programme inclusion and (2) adaptations to the DPP-GLB curriculum including caregiver involvement, TBI-specific physical activity and nutrition recommendations and tracking and presentation of the content. Conclusions: If it is shown to be effective in this population, the modified DPP-GLB for TBI will provide a model for implementation in a variety of community settings.

KEYWORDS:

• Physical activity
• exercise
• diet
• self-management
• weight loss

Acknowledgements

The authors would like to acknowledge the Diabetes Prevention Support Center (DPSC) of the University of Pittsburgh for training, assistance with curriculum adaptation and ongoing support in the Group Lifestyle Balance programme, and Kathleen Richter for her contribution as a Medical Writer for the manuscript.

Declaration of interest

The project was supported by the Ginger Murchison Foundation Traumatic Brain Injury Research Fund. The contents of this manuscript were also developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90DP0045-01-0). NIDILRR is a centre within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government. The authors have no conflicts of interest to report.