The proposed study is the first intervention of its kind and will add to the scientific literature in several important ways: 1. The novel integration of Mindful Eating and Mindful Movement for T2DM: The MEMO trial is the first randomized controlled trial to test the feasibility and acceptability of a combined mindful eating and yoga intervention specifically tailored to adults with T2DM. This study directly addresses the growing prevalence of T2DM and the limitations of current lifestyle recommendations, which often lack strategies that promote sustainable behavior change. By integrating two complementary mindfulness-based components, the MEMO trial aims to holistically address dietary habits, physical activity, and stress management, providing a model for transformative, patient-centered diabetes care. 2. Exploring Mindfulness in Diet and Exercise as a Driver of Behavior Change: By incorporating mindfulness into both dietary and physical activity interventions, this study seeks to address the psychological and behavioral barriers that often hinder long-term diabetes management.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
SINGLE
Enrollment
60
Standard of Care Diet and Exercise Group: Supervised group sessions will be led by a registered dietitian once per week for 60 minutes over 12 weeks, offered in-person or virtually (Zoom) to increase program accessibility. Participants will be encouraged to participate in three 60-minute exercise sessions per week. Two live sessions per week will be led by a trained exercise specialist. Participants will be provided with a prerecorded video session to complete independently at their convenience.
Mindful Eating and Mindful Movement (MEMO) Group: Group mindful eating sessions will be led by a registered dietitian trained in mindful eating strategies. The group will meet once per week for 60 minutes over 12 weeks. Participants will be encouraged to participate in three 60-minute yoga sessions per week (two live sessions and one pre-recorded session to complete at home) over 12 weeks.
Feasibility of a combined mindful eating and yoga intervention
Defined as achieving the target recruitment sample in a 12-month period, 80% retention, 70% attendance rate, and no serious adverse events.
Time frame: Primary endpoint: 12-weeks
Acceptability of a combined mindful eating and yoga intervention
Defined as \>5/7 on acceptability questionnaire (1 = unacceptable, 7 = very acceptable).
Time frame: Primary endpoint: 12-weeks
Mindfulness
The multidimensional construct of mindfulness will be measured using the Five Facet Mindfulness Questionnaire. The minimum value is 1, and the maximum value is 5. A higher score is better and reflects greater mindfulness.
Time frame: Primary endpoint: 12-weeks
Physical Activity Using Accelerometry
Changes in physical activity levels will be measured objectively using accelerometers to capture the time (minutes) spent engaging in MVPA per day. The minimum amount of time is 0 minutes, and the maximum amount of time is 1440 minutes. Higher values are better.
Time frame: Primary endpoint: 12-weeks
Dietary Habits
Dietary intake will be assessed using the Dutch Eating Behavior Questionnaire. The minimum value is 1, and the maximum value is 5. Higher values indicate greater endorsement of the eating behavior.
Time frame: Primary endpoint: 12-weeks
BMI
Height and weight will be measured using a stadiometer and calibrated digital scale, respectively to calculate BMI kg/m\^2
Time frame: Primary endpoint: 12-weeks
Hemoglobin A1c
Change in Hemoglobin A1c will be used as the biomarker for glycemic control.
Time frame: Primary endpoint: 12-weeks
Cortisol
Cortisol sampled from hair will be used as the biomarker for stress levels. The values are determined by the analyzer. Lower scores are better and reflect lower cortisol.
Time frame: Primary endpoint: 12-weeks
Medication Adherence
The Adherence to Refills and Medication Scale for Diabetes (ARMS-D) will be used to measure diabetes medication adherence. The minimum value is 1, and the maximum value is 4. Lower scores are better.
Time frame: Primary endpoint: 12-weeks
Medical History
Participants will complete a comprehensive medical history questionnaire to document changes in health status, including self-reported hypoglycemia as measured by the Clarke Hypoglycemia Awareness Survey. The minimum value is 0, and the maximum value is 7. A higher value is worse and reflects impaired hypoglycemia awareness.
Time frame: Primary endpoint: 12-weeks
Self-Efficacy
The MEMO trial is grounded in Social Cognitive Theory, which highlights self-efficacy as a critical determinant of behavior change. Therefore, we will evaluate the impact of the intervention on participants' self-efficacy and confidence in managing T2DM using the Diabetes Management Self-Efficacy Scale. The minimum value is 1, and the maximum value is 5. Higher scores are better.
Time frame: Primary endpoint: 12-weeks
Subjective Physical Activity
Changes in physical activity levels will be measured subjectively using the International Physical Activity Questionnaire. The minimum value is 0 MET-minutes/week, and the maximum value is 80,640 MET-minutes/week. Higher values are better.
Time frame: Primary endpoint: 12-weeks
Perceived Stress
The Perceived Stress Scale will be used to capture broader stress levels, offering a reliable measure of participants' perceptions of general stress over the past month. The minimum value is 1, and the maximum value is 5. Lower scores are better.
Time frame: Primary endpoint: 12-weeks
Diabetes-Specific Stress
The Diabetes Distress Scale will be used to measure diabetes-specific stressors in participant's lives. The minimum value is 1, and the maximum value is 6. A lower score is better.
Time frame: Primary endpoint: 12-weeks
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