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Transl Behav Med. 2011 Nov;1(4):573-587. doi: 10.1007/s13142-011-0075-6.

Lessons learned when innovations go awry: a baseline description of a behavioral trial-the Enhancing Fitness in Older Overweight Veterans with Impaired Fasting Glucose study.

Translational behavioral medicine

Katherine S Hall, Carl F Pieper, David E Edelman, William S Yancy, Jennifer B Green, Helen Lum, Matthew J Peterson, Richard Sloane, Patricia A Cowper, Hayden B Bosworth, Kim M Huffman, James T Cavanaugh, Jennifer G Chapman, Megan P Pearson, Teresa A Howard, Carola C Ekelund, Beverly L McCraw, Joi B Burrell, Gregory A Taylor, Miriam C Morey

Affiliations

  1. Veterans Affairs Medical Center, Durham, NC, USA.

PMID: 22866170 PMCID: PMC3411119 DOI: 10.1007/s13142-011-0075-6

Abstract

Individuals diagnosed with impaired glucose tolerance (i.e., prediabetes) are at increased risk for developing diabetes. We proposed a clinical trial with a novel adaptive randomization designed to examine the impact of a home-based physical activity (PA) counseling intervention on metabolic risk in prediabetic elders. This manuscript details the lessons learned relative to recruitment, study design, and implementation of a 12-month randomized controlled PA counseling trial. A detailed discussion on how we responded to unforeseen challenges is provided. A total of 302 older patients with prediabetes were randomly assigned to either PA counseling or usual care. A novel adaptive design that reallocated counseling intensity based on self-report of adherence to PA was initiated but revised when rates of non-response were lower than projected. This study presents baseline participant characteristics and discusses unwelcome adaptations to a highly innovative study design to increase PA and enhance glucose metabolism when the best-laid plans went awry.

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