ADAPTING AND ASSESSING THE FEASIBILITY OF A TELEHEALTH DIABETES PREVENTIONPROGRAM FOR HISPANIC ADOLESCENTS

项目摘要 西班牙裔青少年不成比例地负担2型糖尿病（T2 D）和健康的社会决定因素 （SDoH），这可能成为行为改变和参与疾病预防工作的障碍。 远程医疗是一种潜在的有效方法，可为弱势群体提供疾病预防计划。 社区，因为它减少了一些SDoH的负担，如交通，育儿需求和父母的工作 时间表。然而，目前还没有针对西班牙裔的基于理论或证据的远程医疗T2 D预防计划 青年这个职业发展奖的目标是帮助埃里卡索朗博士实现她的长期目标， 一名独立的研究者在高危儿童中设计和实施T2 D预防干预措施 受SDoH影响的人群。Soldier博士的短期目标包括获得使用混合药物的专业知识- 方法，自我决定理论（SDT）和基于技术的干预措施的发展。在 她与她的多学科导师团队合作，制定了一项培训计划，以实现这些目标 通过课程、研讨会、科学会议和指导研究。本研究的目的是适应 埃弗利Little Step Counts（ELSC）是一项以证据为基础、以文化为基础的T2 D预防计划， 通过远程保健，并测试经调整的远程保健干预措施的可行性和可接受性。虽然远程保健是 更适合远程提供营养教育，需要其他基于技术的工具来远程提供营养教育。 促进身体活动（PA）。因此，我们将调整和整合我们以前测试过的干预措施， 活动跟踪器（即Fitbit）和基于SDT的短信，以促进PA进入远程医疗计划。 为确保所有以科技为本的组件均切实可行，并顾及可持续发展目标，我们会采用混合模式- 方法方法在三个迭代阶段进行，以吸引西班牙裔青少年（14-16岁; N=24）及其 父母（N=24）在适应过程中。一旦ELSC远程医疗计划开发，一个新的样本， 将从社区诊所招募肥胖（BMI%≥ 95 th）的西班牙裔青少年（14-16岁; N=40） 并随机分配到为期12周的ELSC远程健康干预组或常规护理对照组。可行性和 将使用先验可行性标准（例如招募、数据收集、保真度）和退出评估可接受性 采访我们将检查干预对PA和T2 D风险结局（禁食）的初步疗效。 葡萄糖、胰岛素、胰岛素抵抗和HbA 1c）。这项建议是在调查小组以前工作的基础上提出的 在T2 D预防、活动跟踪器和短信方面，开发远程医疗提供的T2 D预防 该计划在接触和吸引西班牙裔年轻人方面具有巨大潜力。这项研究将推动科学 远程保健作为受SDoH影响的高危青年的疾病预防工具。完成建议 培训和研究将为Soldier博士提供技能，研究经验，专业发展， 学术产品需要申请R 01资金和过渡到一个成功的，独立的科学家。

Project Summary Hispanic adolescents are disproportionately burdened by type 2 diabetes (T2D) and social determinants of health (SDoH), which can serve as barriers to behavior change and participation in disease prevention efforts. Telehealth is a potentially effective approach for delivering disease prevention programs in vulnerable communities as it reduces the burden of some SDoH like transportation, childcare needs, and parent work schedules. However, there are no theory- or evidence-based telehealth T2D prevention programs for Hispanic youth. The goal of this career development award is to assist Dr. Erica Soltero in her long-term goal of becoming an independent investigator designing and implementing T2D prevention interventions among high-risk pediatric populations impacted by SDoH. Dr. Soltero’s short-term goals include gaining expertise in the use of mixed- methods, the Self-Determination Theory (SDT), and development of technology-based interventions. In collaboration with her multidisciplinary mentorship team, she has developed a training plan to reach these goals via coursework, workshops, scientific meetings, and mentored research. The purpose of this study is to adapt Everly Little Step Counts (ELSC), an evidence-based, culturally grounded T2D prevention program, for delivery via telehealth and test the feasibility and acceptability of the adapted telehealth intervention. While telehealth is more suited for remotely delivering nutrition education, other technology-based tools are needed to remotely promote physical activity (PA). Thus, we will adapt and integrate our previously tested intervention that uses activity trackers (i.e. Fitbit) and text-messages grounded in the SDT to promote PA into the telehealth program. To ensure that all technology-based components are feasible and considerate of SDoH, we will use a mixed- methods approach across three iterative phases to engage Hispanic adolescents (14-16 years; N=24) and their parents (N=24) in the adaptation process. Once the ELSC-telehealth program is developed, a new sample of Hispanic adolescents (14-16 years; N=40) with obesity (BMI%≥95th) will be recruited from community clinics and randomized to the 12-week ELSC-telehealth intervention or usual care control group. Feasibility and acceptability will be assessed using a priori feasibility criteria (e.g. recruitment, data collection, fidelity) and exit interviews. We will examine the preliminary efficacy of the intervention on PA and T2D risk outcomes (fasting glucose, insulin, insulin resistance and HbA1c). This proposal builds on the investigative team’s previous work in T2D prevention, activity trackers, and text messaging to develop a telehealth delivered T2D prevention program with great potential for reaching and engaging Hispanic youth. This study will advance the science on telehealth as a disease-prevention tool among high-risk youth impacted by SDoH. Completion of the proposed training and research will provide Dr. Soltero with the skills, research experience, professional development, and scholarly products needed to apply for R01 funding and transition to a successful, independent scientist.