Weight Management Program for People with Cardiac Disease and Diabetes

a 16 week program of structured exercise twice/week and multidiscipinary information and support sessions (five) aimed at improving participant's weight management habits The structured exercise includes a total of 20 supervised sessions (2 per week) of one hour of planned aerobic exercise and resistance training supervised by expert cardiac rehabilitation staff. The home-based exercise program is tailored by an exercise physiologist at program admission and updated over the first 4 months to include 30-60 minutes of physical activity, including pedometer-recorded steps for the remaining 5 days of the week. The group information and support sessions consist of 4, 90-minute sessions delivered in weeks 1, 2, 4 and 8 of the program. These sessions will be delivered by a multidisciplinary team consisting of a nutritionist, clinical psychologist, exercise physiologist and cardiac rehabilitation clinical nurse consultant. Session content will include information about nutrition and exercise aimed at weight reduction and modified for diabetes mellitus and cardiovascular disease; the health implications of being overweight; behavioural change, potential barriers and strategies for self management. Session processes will be interactive, teaching participants how to use food and exercise diaries, with subsequent sessions using these diaries to help develop the capacity to problem-solve, foster motivation and gain a sense of mastery. All content and processes will be based on behavioural and cognitive behavioural therapy tenets and guided by Social Learning Theory and the Transtheoretical Model of Change. Phase 2 of the program is designed to support participants’ continued weight loss behaviours and strategies and will include a one-hour session at 16 weeks (following the assessment schedule) and telephone follow-by one team member on three occasions between 4 and 12 months. The group session will focus on problem-solving and motivation using similar content and processes to the Phase 1 program.