Development and evaluation of a multicomponent intervention to improve aerobic and muscular fitness among adults at-risk of, or diagnosed with type 2 diabetes: the ‘Ecofit’ randomised controlled trial

Growing concerns over the alarming number of people at risk of, or diagnosed with type 2 diabetes (T2D) has led to a proliferation of lifestyle behavioural interventions to prevent or delay the onset of this chronic disease. The benefits of regular aerobic and resistance training activities are well-established, and physical inactivity has been identified as a significant risk factor for the onset and progression of T2D. However, the initiation and maintenance of regular physical activity is challenging for this population and novel strategies are warranted to improve daily activity. The rapid development of smartphone technology provides a platform which can foster physical activity behaviour change. Additionally, effective cost-free alternatives for physical activity behaviour change could reduce barriers related with the financial burden of using sports facilities. The outdoor environment offers an ideal setting to promote aerobic and resistance training activities. Whilst community-based physical activity interventions have been somewhat effective in targeting changes at the individual level, few interventions have incorporated the use of physical environments in conjuction with social support. Moreover, very few interventions have focused on promoting resistance training using features of the outdoor built environment. As such, there is a need to implement novel, multi-component interventions to promote physical activity amongst individuals at risk of or diagnosed with T2D. This thesis developed and evaluated the efficacy of the eCoFit intervention and highlights the potential of a novel, multi-component intervention for T2D treatment and prevention. The information presented within this thesis has important implications for research and practise regarding the promotion of outdoor physical activity among T2D population. The effective and scalable intervantions are urgently required to combat the rising prevalence of T2D.