Lifestyle Program - TODAY
The TODAY Lifestyle Program (TLP) was designed to be administered in three phases. A Personal Activity-nutrition Leader (PAL) on the staff of each TODAY clinical center delivered the program to the youth participant and family support person (FSP, the adult caregiver who formed a supportive partnership with the youth during the study). The PAL was overseen by a supervising psychologist.
The three phases of the TLP are:
1. Lifestyle Change (LC) focuses on achieving weight, physical activity, and behavior change goals. A set curriculum is presented to ensure that a standard program is delivered. LC lasts a minimum of 6 months to a maximum of 8 months, during which time 24 lessons are covered in weekly in-person meetings.
2. Lifestyle Maintenance (LM) also delivers a set curriculum focusing on strengthening and reinforcing skills and concepts introduced during the LC phase, and preserving the positive changes that were accomplished during this phase. The LM phase also promotes further dietary and physical activity changes where appropriate. The LM extends a minimum of 6 months and a maximum of 8 months after the end of the LC phase. Weekly delivery alternates between in-person visits (total of 12) and phone sessions (also 12). Participant, FSP, and PAL choose from 20 available educational modules, in addition to being able to continue to use the materials and modules from the LC phase.
3. Continued Contact (CC) focuses on helping participants solve problems as they arise in order to avoid a return to unhealthy, preexisting behaviors, and to continue to work towards change where appropriate. This phase does not have set topics to review. Instead, a library of topics is available from which to draw relevant information for working with families on specific issues. Contact during the CC phase is intended to maintain the team approach to diabetes care and management, while transferring more responsibility to the youth as he/she ages. The phase starts with monthly in-person meetings with the youth and FSP and a phone call in between monthly sessions for about 12 months, followed by in-person visits held in conjunction with regular quarterly clinic visits. Other forms of contact, such as phone calls, e-mail, texting, etc., may be used to keep connected and informed.
Click on the 'Publications' tab to download the TODAY publication ‘Design of a family-based lifestyle intervention for youth with type 2 diabetes: the TODAY study' (published in International Journal of Obesity 2010, volume 34, pages 217–226).
In order to participate in TODAY, youth had to speak and read English; many materials are also provided in Spanish in order to involve family members who do not know English.