Fit24: Using technology to improve activity and sleep in Hispanic youth

PROJECT SUMMARY Hispanic adolescents are disproportionately burdened by obesity and exhibit greater risk for type 2 diabetes (T2D) compared to non-Hispanic white youth. These disparities are driven in part by unhealthy wake time physical activity (PA) and sedentary behaviors (SB), and short sleep durations. Lifestyle interventions that

address these behaviors have effectively reduced T2D risk in high-risk adults. However, few studies have developed and tested T2D prevention interventions for Hispanic youth and even fewer have focused on improving both wake time and sleep behaviors. Technology-based devices like Fitbit activity monitors have been

increasingly used as behavior change tools in obesity prevention interventions. Studies that have utilized wearable devices in conjunction with text-messaging have been effective in increasing physical activity in adults. However, more research is needed to test the feasibility of wearable devices as a health promotion and disease

prevention strategy among minority youth. The purpose of this study is to examine the feasibility of a 12-week goal-setting intervention that utilizes a Fitbit device and text messages grounded in the Self-Determination Theory (SDT) to promote healthy wake time (PA,SB) and sleep behaviors in Hispanic adolescents (14-16-years

old) with obesity (BMI%≥95th). In collaboration with Hispanic youth (N=20) and an expert panel (N=6), text message content will be adapted and refined from a previously conducted pilot study. A mixed methods approach (surveys and interviews) will be applied to ensure that text message content adheres to the SDT and is age and

culturally appropriate. A different sample of Hispanic youth (N=48) will be recruited and randomized to the intervention or a wait-list control group. In the intervention, youth will receive guidance from the research team on setting weekly steps/day and hours of sleep/night goals, a Fitbit device to self-monitor progress towards goals,

and theory informed text messages that promote autonomous motivation for behavior change. Feasibility will be evaluated using a priori criteria for recruitment, data collection, intervention implementation, and acceptability. This proposal builds on preliminary data and leverages a strong, transdisciplinary investigative team to address

critical gaps in diabetes prevention research among high-risk Hispanic adolescents. This feasibility study will be instrumental in providing the preliminary data needed to build towards a more rigorous, fully powered efficacy trial (R01). If this innovative approach is found to be feasible, it has the potential to be an affordable and scalable

solution-oriented approach to T2D prevention in Hispanic youth and other populations of high-risk youth.