A co-designed, community-based intensive health behavior intervention promotes participation and engagement in youth with risk factors for type 2 diabetes

Julie M Pike; Kathryn M Haberlin-Pittz; Basmah S Alharbi; Susan M Perkins; Tamara S Hannon

doi:10.3389/fcdhc.2023.1264312

A co-designed, community-based intensive health behavior intervention promotes participation and engagement in youth with risk factors for type 2 diabetes

Front Clin Diabetes Healthc. 2023 Dec 1:4:1264312. doi: 10.3389/fcdhc.2023.1264312. eCollection 2023.

Authors

Julie M Pike^{1

2}, Kathryn M Haberlin-Pittz^{1

2}, Basmah S Alharbi³, Susan M Perkins^{3

4}, Tamara S Hannon^{1

2}

Affiliations

¹ Department of Pediatric and Adolescent Comparative Effectiveness Research, Indiana University School of Medicine, Indianapolis, IN, United States.
² Department of Pediatric Endocrinology, Riley Children's Health, Indiana University Health, Indianapolis, IN, United States.
³ Department of Biostatistics and Health Data Science, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, United States.
⁴ Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States.

Abstract

Background: Obesity among youth (children and adolescents) is associated with increased risk for youth-onset type 2 diabetes. Lifestyle change can delay or prevent the development of type 2 diabetes, yet real-world implementation of health behavior recommendations is challenging. We previously engaged youth with risk factors for type 2 diabetes, their caregivers, and professionals in a human-centered design study to co-design a lifestyle change program. Here we report the outcomes for this 16-week co-designed lifestyle change program for youth at risk for T2D and their caregivers.

Research design and methods: This single-arm family-based cohort study included youth aged 7-18 years, with BMI ≥85^th percentile (overweight or obese) and at least one additional risk factor for type 2 diabetes, and their caregivers. Clinical (BMI, HbA1c), self-reported physical activity, and quality of life outcomes were evaluated at baseline (B), post-intervention (M4), and 1 year (M12) following the intervention.

Results: Seventy-eight youth (mean age 12.4 ± 2.7y, 67% female, 37.8% white) and 65 caregivers were included in the data analysis. Youth baseline BMI z-scores (2.26 ± 0.47) and HbA1c (5.3 ± 0.3) were unchanged at follow up time points [BMI z-scores M4 (2.25 ± 0.52), M12 (2.16 ± 0.58), p-value 0.46], [HbA1c M4 (5.3 ± 0.3), M12 (5.2 ± 0.3), p-value (0.04)]. Youth reported increased physical activity at M4 (p = 0.004), but not at M12. Youth quality of life scores increased at M12 (p=0.01). Families who attended at least one session (n=41) attended an average of 9 out of 16 sessions, and 37 percent of families attended 13 or more sessions.

Conclusion: A co-designed, community-based lifestyle intervention promotes increased physical activity, improved quality of life, maintenance of BMI z-scores and HbA1c, and engagement in youth with risk factors for T2D.

Keywords: adolescents; community-engaged research; diabetes prevention; human-centered design; lifestyle intervention; obesity; pediatric; physical activity.

Abstract

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