Table 1.
Details of the SLIMMER lifestyle intervention programme according to the implementation manual
| Intervention components | Sub-components | Number | Time (min) | Details |
|---|---|---|---|---|
| Dietary intervention | Consultations (incl. intake) | 5–8 (individual) | Max. 240 | ∙ Aim: adopt sustainable healthy dietary pattern; 5–10 % weight loss |
| ∙ 60 min intake consultation to obtain information on social and environmental factors, perform dietary assessment and set goals | ||||
| ∙ Formulate treatment plan (including goals and advice) | ||||
| ∙ Inform, advise and guide participants in adapting dietary pattern | ||||
| ∙ Based on Dutch dietary guidelines( 28 ) | ||||
| ∙ Discuss topics: Dutch dietary guidelines, fats, carbohydrates and fibre, sweeteners, special occasions, and explain the relationship between nutrition and glucose tolerance | ||||
| ∙ Make use of motivational interviewing and positive feedback | ||||
| ∙ Spouses could join | ||||
| ∙ Set, evaluate and adjust goals | ||||
| ∙ Divide consultations over 10 months | ||||
| Group meeting | 1 (group-based) | 90 | ∙ Aim: share experiences, motivate one another and provide information | |
| ∙ Discuss topic: label reading | ||||
| ∙ Compare products on fat and sugar content | ||||
| ∙ Plan this group meeting halfway through the intervention | ||||
| Physical activity (PA) intervention | Intake | 1 (individual) | 30 | ∙ Aim: obtain information on current PA, needs, abilities, motivation and barriers to PA |
| ∙ Set goals | ||||
| Sports lessons | 40–80 (group-based) | 60 (per lesson) | ∙ Aim: achieve moderate-intensity PA for at least 30 min/d at least five days per week | |
| ∙ 2/3rd of training is aerobic exercise (60–70 % of VO2max) | ||||
| ∙ 1/3rd of training is resistance exercise (55–60 % of 1 repetition maximum, with 3×15 repetitions, for major muscle groups) | ||||
| ∙ Offer group-based activities | ||||
| ∙ Individually tailored guidance | ||||
| ∙ Improve level of ability | ||||
| Advice on PA during leisure time | – | – | ∙ Aim: encourage participants to be physically active during leisure time | |
| ∙ Discuss PA possibilities during leisure time | ||||
| ∙ If necessary: formulate an individual plan for PA during leisure time | ||||
| Case management | Contact with health-care professionals and participants | 2 phone calls (individual) | – | ∙ Aim: monitor participants’ progress |
| ∙ Facilitate contact among health-care professionals | ||||
| ∙ Detect and solve problems | ||||
| ∙ Motivate and encourage participants | ||||
| Maintenance programme | Intermediate evaluations by dietitians and physiotherapists | 3 (individual) | – | ∙ Aim: keep participants motivated, prevent dropout (at 3, 6 and 9 months) |
| ∙ Provide feedback and discuss experiences with programme | ||||
| ∙ Assess individual progress (using measurements of weight, waist circumference and body fat percentage) | ||||
| ∙ Evaluate personal goals and adjust goals if necessary | ||||
| ∙ Stimulate self-management | ||||
| Sports clinics | 2–7 (group-based) | 60 (per clinic) | ∙ Aim: introduce participants to different types of sports and sports organisations to achieve sustainable behaviour change | |
| ∙ During times of regular sport lessons | ||||
| Final interview dietitian/ physiotherapist | 2 (individual) | – | ∙ Aim: strengthen participants’ self-efficacy and motivation | |
| ∙ One final interview with dietitian during last consultation and one final interview with physiotherapist during last sports lesson | ||||
| ∙ Provide positive feedback | ||||
| ∙ Discuss behaviour maintenance (goal setting and self-monitoring) | ||||
| ∙ Inform about relapse prevention | ||||
| Return visit | 1 (group-based) | 60 | ∙ Aim: prevent relapse and motivate and support participants to maintain behaviour change | |
| ∙ Dietitian and physiotherapist are present | ||||
| ∙ Discuss behaviour maintenance during last 3 months/share experiences | ||||
| ∙ Measurements of weight, waist circumference and body fat percentage | ||||
| ∙ Discuss relapse and relapse prevention | ||||
| ∙ Provide tips for behaviour maintenance |