Document Type



Background: Among adults with diabetes, 19-34% will develop a diabetic foot ulcer (DFU), which increases amputation risk and health care costs, and worsens quality of life. Regular physical activity, when increased gradually, may help prevent DFUs. In this mixed-methods study, we examined the feasibility of a low-intensity, technology-based behavioral intervention to increase activity in adults at risk for DFUs. Method: Participants at risk for a DFU (n = 12; 66% female; mean age = 59.9 years) received four in-person exercise and behavioral counseling sessions over 2-3 weeks, supplemented with use of an activity monitor (to track steps) and text messages (to reinforce behavioral strategies) for an added 8 weeks. Pre- and postintervention assessments of accelerometer measured activity, daily mobility, and glycemic control (A1C) were completed. Treatment acceptability was assessed by questionnaire and via key informant interview. Results: The program appears feasible since all but one participant attended all four sessions, all used the activity monitor and all responded to text messages. Treatment acceptability (scale: 1 = very dissatisfied, 5 = extremely satisfied) was high; average item ratings were 4.79 (SD = 0.24). Participants increased their steps by an average of 881.89 steps/day (d = 0.66). A1C decreased on average by 0.33% (d = 0.23). Daily mobility did not change. Interview results suggest that participants perceived benefits from the intervention. Participant recommended improvements included providing more physical activity information, addressing pain, and intervention delivery in a podiatry clinic. Conclusion: Individuals at risk for a DFU might benefit from a minimally intensive, technology-based intervention to increase their physical activity. Future research comparing the intervention to usual care is warranted.



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Symposium/Special Issue

Original Citation

Schneider, K.L., Crews, R.T., Subramanian, V., Moxley, E., Hwang, S., DiLiberto, F., Aylward, L. Bean, J., Yalla, S.V. (2019). Feasibility of a low intensity, technology-based intervention for increasing physical activity in adults at risk for a diabetic foot ulcer: a mixed methods study. Symposium/Special Issue: Journal of Diabetes Science and Technology.

Legacy Department

School of Nursing and Health Studies


The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by a DePaul University–Rosalind Franklin University of Medicine and Science Collaborative Pilot Project to KLSchneider, RTCrews, EMoxley, and SHwang.



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