Exercising options in diabetes care
For people with diabetes, exercise is vital, yet many struggle to achieve the level they need. A new resource developed by Dr. Chris Shields and his colleagues has become a cornerstone of diabetes care in Canada.
Exercise. We know it鈥檚 good for us. So why do we reach for one more french fry and slump farther into the sofa for one more TV program? More to the point, how can we be persuaded to get off the sofa and get active?
, associate professor in Acadia鈥檚 Department of Kinesiology, knows the answer.
Shields has won a $5,000 Petro-Canada Young Innovator Award for a project that set out to encourage those with diabetes in Nova Scotia to exercise more. The project has now been adopted nationally by the .
Closing a gap
鈥淭here鈥檚 a real gap in diabetes management that we鈥檝e found around physical activity and exercise,鈥� Shields says.
Many diabetes educators have trained as dietitians or nurses; they鈥檙e not trained in prescribing physical activity and exercise. Yet lack of exercise contributes to the development of type 2 diabetes, and exercise is a major tool for managing the condition.
To close this gap, Shields and Dr. Jonathon Fowles (LINK: http://kinesiology.acadiau.ca/jonathon-fowles.html) developed an exercise toolkit with colleagues at Acadia. It began as a resource manual, an exercise program, and a video for diabetes centres in Nova Scotia, funded partly by the .
Regional interest followed, and the program spread throughout Atlantic Canada. Then came talks with the Canadian Diabetes Association. Today, the toolkit is a standard of care for diabetes education across Canada.
Between them, Shields and Fowles trained more than 1,000 diabetes educators in workshops across Canada last year.
Personal interest
Shields鈥� interest in kinesiology 鈥� the study of human movement 鈥� goes back a long way.
鈥淢y training is in kinesiology all the way up from undergrad through to my doctoral and postdoctoral work,鈥� he says. He has also worked as a personal trainer. More recently, he has worked with the and the Canadian Diabetes Association on programs aimed at improving the physical-activity counselling of healthcare professionals.
He is particularly interested in the interactions of healthcare professionals with their patients or clients, and how these interactions shape what clients think and how they act. Such interactions tend to be brief and infrequent 鈥� we may see our doctor three or four times a year 鈥� but they can have a big effect in the way we think about our health.
Shields has done a lot of work on this topic. When healthcare professionals want to prescribe exercise or need information about it, they鈥檒l go to a physiologist. However, physiologists are not experts in behaviour change 鈥� in knowing how to motivate people to put an exercise prescription into practice.
鈥淓specially in the work in diabetes, confidence is a major issue on both sides of the table,鈥� Shields says. Diabetes educators weren鈥檛 confident in their ability to talk about physical activity or prescribe it, and patients weren鈥檛 confident in their ability to do the prescribed activity.
鈥淲e began providing individuals with what we call 鈥榤astery experiences鈥� 鈥� experiences where they gained some success,鈥� Shields says. Once people achieve a little success, they build on it as a stepping stone to being active enough to see real changes. 鈥淔ostering that sense of confidence is how you get them to where they can be active enough,鈥� he says.
Students at the hub
鈥淪tudents have been integral to the project since we started in 2008 with the local work in diabetes,鈥� says Shields. 鈥淲e鈥檝e had honours students working from the get-go, and we鈥檝e employed two recent graduates.鈥� As program coordinators, they were the hub of contact for the diabetes educators in terms of asking questions, obtaining materials, and planning workshops.
, currently in the PhD program at McMaster University, was one of Shields鈥� honours students early on. In 2010, she co-authored an award-winning article based on the project in the .
Part of the Petro-Can award will pay an Acadia student to evaluate the toolkit鈥檚 use across Canada.
Tapping into Acadia鈥檚 culture
Acadia鈥檚 small size encourages collaboration across disciplines, Shields believes.
鈥淎lthough I was given the award, the diabetes project really has been a collaborative effort,鈥� he says. 鈥淚鈥檝e been a key player, but Dr. Fowles has been the leader in pushing the boundaries of where I can go. Dr. Fowles and I have different expertise, but we feel very comfortable collaborating. And I think that鈥檚 the culture here at Acadia.
鈥淚t鈥檚 been fun to work on it and to see the enthusiasm behind it,鈥� he adds. 鈥淲e get a lot of positive feedback about the fact that the Canadian Diabetes Association now has tools to use for physical activity, where they didn鈥檛 before.鈥�
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