Interventions
T2D
BLIND
The timeline of the intervention activities and measurements for ILSM group and control group is showed in Table The flowchart of the intervention activities and measurements(1) the T2D risk score;(2) glycemic outcomes: FBG, 2 h-OGTT;(3)weight-related outcomes: BMI, waist circumference;(4) behavior outcomes: physical activity, fruit/vegetable consumption, intention to eat low glycemic-index foods;(5) psychological outcomes: perceived stress, quality of life, general self-efficacy, social support.The intervention group also received the ILSM program from eight trained local nurses following the ILSM protocol reported elsewhere [Each nurse conducted the intervention for a group of ~ 20 participants from the same town at the research-designated hospitals. Participants were invited to attend six biweekly group seminars (90 minutes) and eight telephone consultation sessions (20 minutes each). The topics of group seminars included orientation and goal-setting, healthy eating patterns, physical activity, stress management, family support, family lifestyle patterns, and relapse prevention and farewell [To promote the long-term efficacy of the intervention, a series of strategies such as setting recursion goals and providing a environmental support, was used. For example, participants were required to set various small and easy-to-implement goals concerning health behavior at the early stage of intervention to ensure their early behavioral wins. These early wins help convince participants that behavior change is possible, thus induced into a recursive process and eventually sparking a positive and continual behavior change loop. In addition, participants were equipped with resources of health behavior change during the intervention, and these resources create supportive physical and psychological environment after intervention. By interacting with these essential elements and repeatedly reinforcing the desired behavior via environment, long-term benefits will tend to persist and reinforce the behavior change.Due to the nature of educational and behavioral interventions, it was not feasible to blind participants and local nurses (investigators), though data assessors were blinded. Nurses and study participants were asked to sign an agreement that they would not share the intervention materials or protocol with others before the completion of the study.