An mHealth Intervention to Increase Activity Among Patients at Risk for Type 2 Diabetes

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 DESCRIPTION (provided by applicant): Patients with type two diabetes (T2D) frequently lead sedentary life styles which are not only a risk factor for diabetes, but can also exacerbate the disease. Recommending increased physical activity is therefore a cornerstone of T2D prevention and management. Historically, increasing activity was synonymous with exercise; however, we now know that even much more modest activity levels (e.g., simply walking) or merely decreasing the proportion of sedentary time may be sufficient to improve health outcomes. Some interventions designed to increase activity have shown promise; others have been less successful. The availability of inexpensive pedometers, and, more recently, low cost triaxial accelerometers, has now made it much easier to monitor activity levels and provide feedback to users. These devices are ideal for capturing activity associated with walking, the most popular and acceptable form of exercise for patients with T2D, but only if patients actually wear them. Thus, there is a need to develop pragmatic approaches that encourage patients to not only wear these monitoring devices, but also to motivate them to increase their activity. The overarching goal is of this proposal is to develop new practical, affordable, and easy-to-use approaches to increase activity among patients at risk for developing T2D and those already diagnosed with T2D. To achieve this goal we will test MapTrek, an m-health game or our own design that uses low cost triaxial accelerometers to encourage patients to walk more, and we will test this m-health intervention against a control group using the accelerometers alone. The data we generate will help inform a larger pragmatic trial to investigate long-term clinical outcomes and costs.