Using response variation to develop more effective, personalized behavioral medicine?: evidence from the Resist Diabetes study.

Abstract

Health behavior interventions have achieved some notable outcomes through generally higher dose interventions with intensive initial phases and long-term, faded contact maintenance phases with attention to mean changes and adherence rates. Interventions may be improved by shifting attention to the very large response variation that is typical for such protocols as exercise with non-, low, moderate, and high responders and even those who show adverse responses. Data from the Resist Diabetes study, which included adults (N = 159, ages 50-69 years) with prediabetes who were overweight or obese (BMI 25-39.9 kg/m(2)) and previously inactive, are presented. The data show a typical pattern of wide variation for changes on a 2-h oral glucose tolerance test (OGTT), defined by blood glucose concentration measured after 2 h following ingestion of 75 g of glucose, lean body mass, fat mass, strength, and blood pressure to the same resistance training protocol within a highly supervised phase and where adherence was high. A personalized behavioral medicine approach could focus on such individual patterns of response variation to tailor and alter additional intervention components, the staging of maintenance interventions, and then determining how to most effectively, and systematically, translate this adaptive intervention approach into practice to potentially achieve more optimal clinical outcomes.