There are significant disparities in the prevalence of overweight/obesity, with African-American urban adolescents and young adults commnonly affected. Many of them develop metabolic arrangements characteristic of pre-type 2 diabetes and, without intervention, eventually progress to type 2 diabetes. Behavioral interventions are required to motivate behavioral change, reduce weight, and eventually prevent the development of type 2 diabetes. Cell phone text messaging has already shown promise in engaging diabetic youth and young adults to self monitor their blood glucose. Cell phones are portable, widely used and accepted by adolescents and young adults. Exciting preliminary evidence is available suggesting that use of Web-enabled cell phone technology is useful in the management of adult patients with diabetes. The overall objective of the proposed study is to implement and rigorously evaluate the preventive benefits in adolescents of this innovative program successfully applied in adult patient management that includes state of- the-art communications and networking technologies. To achieve this objective, the specific aim of this proposal is to compare the effectiveness of a lifestyle change intervention delivered either using state-of-theart communications and networking technologies or using Lifestyle Group Visits. Young adults 18-24 years of age with a diagnosis of pre- type 2 diabetes will be referred to the Howard University Hospital Diabetes Treatment Center for participation in this project. Participants will be recruited from clinics at Howard University Hospital, a minority-serving institution. Eligible and consenting youth will be randomized to one of the 2 treatment groups as described above. A validated measure of patient activation will be the primary outcome, and be assessed at baseline, three months, six months and one year following intervention. Both within and between group changes will be assessed, and additional biophysiologic outcomes (body mass index and hemoglobin AlC) will also be monitored at the same time points. Study findings have significant implications in addressing an important disparity in early health morbidity. Our analyses will test whether the extension of cell phone technology with access to health information through web-enabled PHR'and educational portals yield promise as a preventive intervention among African American late adolescents/young adults at risk for type 2 diabetes.

Public Health Relevance

Minority populations have been severely affected by obesity and type 2 diabetes. This study proposes the use of cell phone networking technology to enhance lifestyle skills to prevent type 2 diabetes in high risk African American adolescents/young adults. This program has already demonstrated to be effective in adult diabetes management.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Exploratory Grants (P20)
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Special Emphasis Panel (ZMD1-RN)
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Howard University
United States
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