Fit24, a digital health intervention to reduce type 2 diabetes risk among Hispanic youth: Protocol for a feasibility pilot study

Authors: SOLTERO, ERICA - Children'S Nutrition Research Center (CNRC); LOPEZ, CALLIE - Children'S Nutrition Research Center (CNRC); MUSAAD, SALMA - Children'S Nutrition Research Center (CNRC); O'CONNOR, TERESIA - Children'S Nutrition Research Center (CNRC); Thompson, Deborah - Debbe

Submitted to: Contemporary Clinical Trials
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/8/2023
Publication Date: 2/10/2023
Citation: Soltero, E.G., Lopez, C., Musaad, S.M., O'Connor, T.M., Thompson, D.J. 2023. Fit24, a digital health intervention to reduce type 2 diabetes risk among Hispanic youth: Protocol for a feasibility pilot study. Contemporary Clinical Trials. 127. Article 107117. https://doi.org/10.1016/j.cct.2023.107117.
DOI: https://doi.org/10.1016/j.cct.2023.107117

Interpretive Summary: About 90% of today's youth have a smartphone and adolescents are the highest users of text-message based communication. Therefore, using text-messages to encourage healthy lifestyle behaviors is a promising strategy for reaching and engaging youth. However, to make sure that text-message content is relevant to today's adolescents, it is important to include youth as co-collaborators in the design and development process. The purpose of this study was to co-design a bank of text messages with Hispanic adolescents with obesity to encourage healthy physical activity and sleep behaviors. Participating youth completed interviews to identify barriers and facilitators of physical activity and sleep and to identify the type of support needed to improve these behaviors. This information was used to develop an initial bank of text messages that was reviewed and evaluated by a panel of youth and research experts. Using their feedback, our final, revised text message bank included 125 unique messages that were <=160 characters, used engaging features like emojis, pictures, and videos, and integrated evidence-based behavior change techniques to overcome youth-identified barriers so they can improve their activity and sleep. The co-design process used in this study will serve as a guide for future studies aiming to engage youth as co-collaborators to develop text-message based strategies that promote healthy lifestyle behaviors.

Technical Abstract: Poor physical activity (PA) and sleep behaviors in Hispanic adolescents contributes to increased risk for type 2 diabetes. Commonly owned digital devices and services like smartphones and text-messaging are highly used among adolescents and are promising intervention tools for reaching this age group. Personal activity trackers assess activity and sleep, making them ideal tools for addressing these behaviors. We propose to examine the feasibility of a 12-week intervention that uses theoretically grounded text messages and a Fitbit device to improve PA and sleep among Hispanic adolescents with obesity, as compared to a wait-list control group with a Fitbit device only. Participants (N=48; 14-16 years) will be randomized (1:1) to the intervention or wait-list control group. Youth in the intervention will receive a Fitbit Charge 5 and daily text messages. Youth in the wait-list control group will receive a Fitbit Charge 5 and information on PA and sleep guidelines. Feasibility will be examined by collecting process evaluation data on the following criteria: (1) recruit 48 Hispanic adolescents 14-16 years; (2) retain 85% of participants for post-assessments; (3) Fitbit wear >=4 days/week and respond to 80% of text messages when prompted; (4) <=10% technical issues; and (5) obtain 80% satisfaction from participants. This study will advance our knowledge on the feasibility of digital prevention strategies to promote PA and sleep behaviors to reduce T2D risk among Hispanic youth. If feasible, this approach has the potential to be a scalable, cost-effective diabetes prevention strategy among high-risk youth.