Mobile Health App to Reduce Diabetes in Latina Women with Prior Gestational Diabetes

摘要 拉美裔社区受到新冠肺炎大流行的影响不成比例，两人都在 感染时风险增加，并经历更严重的疾病。居住在波多黎各的拉丁裔也有 通过获取健康食品而受到影响。即使在大流行之前，获得健康食品的机会就已经很少了 由于史无前例的一系列自然灾害，包括2017年的飓风玛丽亚，我们受到了威胁。一开始 新冠肺炎的使用进一步威胁到人们获取健康食品的途径。与此相关的是，社交距离规则限制了 前往海滩、公园及公众康乐场地，以防止这些地方出现不健康的挤迫情况，可 对依赖这些空间进行身体活动的低收入波多黎各人产生更大的负面影响。 虽然公众对健康购物、健康饮食和体育锻炼的建议 新冠肺炎已经出现，但这些建议并不针对拉丁裔，也不适用于 西班牙语。波多黎各人将受益于有针对性的健康购物和饮食指导，因为 新冠肺炎之前已经存在的普遍的粮食不安全和贫困，以及体力活动指导 由于新冠肺炎的相关限制，户外体力活动受到限制。 波多黎各居民广泛使用的数字技术是帮助家庭参与 面对新冠肺炎的健康行为，因为它通过为健康提供行为工具来克服障碍 购买食物和准备食物，并提供增加体力活动的方法。量身定做这个 向拉丁裔提供信息，他们通常在拉丁裔家庭中管理购物和食物准备， 增加其影响力。据我们所知，没有专门针对数字健康干预的，以及 与拉丁裔共同设计，以促进健康食品购物、健康饮食和身体活动 新冠肺炎。虽然这种干预对许多拉丁裔亚群具有潜在价值，但波多黎各人 代表高优先级目标，因为先前存在的几个天然漏洞 新冠肺炎之前的灾难。 这份竞争性增刊的总体目标是开发一种文化和个人定制的西班牙语/ 英语数字健康干预，促进健康食品购物和健康饮食，以及身体健康 在新冠肺炎大流行期间及其后果中波多黎各拉丁裔的活动。这是竞争激烈的 修订扩大了我们目前SBIR第二阶段母公司赠款(Hola Bebé)的范围，该项目正在建设和 使用健康饮食和体力活动工具测试数字健康干预 妊娠期糖尿病(GDM)病史，以及我们的SBIR第一阶段项目(LISTA)的基础上，该项目 为拉丁裔开发了健康购物和饮食的工具。我们致力于迅速传播 大流行期间及其后果期间的移动应用程序，面向各地社区卫生中心的拉丁裔用户 波多黎各，以及其他拉丁裔获得食物的网站。

Abstract Latino communities have been disproportionately impacted by the COVID-19 pandemic, being both at increased risk and experiencing more severe illness when infected. Latinos living in Puerto Rico have also been affected via access to healthy food. Even before the pandemic, access to healthy food had been threatened due to the unprecedented series of natural disasters, including Hurricane Maria in 2017. The onset of COVID-19 has further threatened access to healthy food. Relatedly, social distancing rules, which limit access to beaches, parks and public recreation areas to prevent unhealthy crowding in these spaces, may have a greater negative impact on low-income Puerto Ricans who rely on these spaces for physical activity. While public health recommendations for healthy shopping, healthy eating, and physical exercise during COVID-19 have emerged, these recommendations have not targeted to Latinos nor are they available in Spanish. Puerto Ricans would benefit from targeted healthy shopping and eating guidance due to the widespread food insecurity and poverty that already existed prior to COVID-19, and physical activity guidance due to the COVID-19 related constraints to outdoor physical activity. Digital technology, which is widely used by Puerto Rico residents, is a way to help families engage in healthy behaviors in the face of COVID-19, as it overcomes barriers by providing behavioral tools on healthy food shopping and food preparation, and providing ways to increase physical activity. Tailoring this information to Latinas, who typically manage shopping and food preparation in Latino families, would increase its impact. To our knowledge, no digital health intervention has been specifically targeted to, and co-designed with Latinas to promote healthy food shopping, healthy eating, and physical activity during COVID-19. While such an intervention has potential value for many Latino subgroups, Puerto Ricans represent a high-priority target because of pre-existing vulnerabilities brought about by several natural disasters that preceded COVID-19. The overall goal of this competitive supplement is to develop a culturally- and individually-tailored Spanish/ English digital health intervention to promote healthy food shopping and healthy eating, as well as physical activity, among Puerto Rican Latinas during the COVID-19 pandemic and its aftermath. This competitive revision expands the scope of our current SBIR Phase II parent grant (Hola Bebé), which is building and testing a digital health intervention with tools for healthy eating and physical activity for Latinas with a prior history of Gestational Diabetes Mellitus (GDM), as well as builds on our SBIR Phase I project (LISTA), which developed tools for healthy shopping and eating for Latinas. We are committed to the rapid dissemination of the mobile app during the pandemic and its aftermath, to Latina users of community health centers throughout Puerto Rico, as well as other sites where Latinas access food.