Table 1 Outline of the DiAlert programme for first degree relatives of people with type 2 diabetes

Session 1

150 min.

- Introduction

10

General introduction trainer and observers are introduced.

State aims and proceedings of the two group sessions.

- Participant topics

30

All participants are asked about family members with T2DM, and will be encouraged to explore their knowledge, concern and possible impact of T2DM. Motives for participating and burning questions of participants are listed.

Introduction of participants, personal models about T2DM are explored.

- View on personal risk factors

30

Participants share current knowledge of risk factors for T2DM and discuss modifiable and non-modifiable risk factors.

Increase risk perception

30

break

- How to prevent T2DM?

30

Participants learn about insulin resistance, loss of beta cell function and the positive effects of body weight loss and physical activity.

Increase outcome expectancies for weight loss and physical activity

- Energy balance

10

Advice based on recommendations on nutrition and physical activity. Balancing calorie intake and energy expenditure per day.

Increase outcome expectancies for weight loss and healthy diet

- Homework assignment

10

Self-monitoring diet and physical activity (diary).

Monitoring current lifestyle behaviour

Session 2

150 min.

- Reflections

10

Summary of session 1: Participants reflect on issues raised by the program so far.

Discussing topics of the first session

- Taking control: Nutrition and exercise balance

40

Introduction to calories by comparing different food products. Reading nutrition fact labels.

Knowledge and skills for food choices (calorie and fat intake) to reduce risk factors

30

break

- Personal action plan

45

Sharing experiences about losing weight. Exploring benefits and barriers for lifestyle change. Participants' stories are used to summarise possibilities/facilities to lose weight. Participants formulate personal action plans to change lifestyle.

Action planning, coping planning and self efficacy for formulated goals

- Burning questions

15

Check whether all questions raised by participants throughout the two group sessions have been answered and understood.

All questions of participants are answered

- Conclusions

10

Summary

Conclusions of the two session are summarised

Newsletters

- 4 Newsletter

4 newsletters are sent by mail with information about health behaviour change following HAPA framework and tips for healthy eating and increasing physical activity.

Focus of the 4 newsletters:

1. outcome expectancies and self efficacy

2. Self efficacy, coping with barriers.

3. Intentions and maintenance

4. Maintenance