Diabetes Prevention for Hispanics Residing in Rural Communities: A Mobile Web-based Approach

Isa Associates, Inc., Alexandria VA

Investigators

Abstract

Abstract Diabetes is a public health threat and is the 5th leading cause of death among Hispanics in the United States. There are several risk behaviors that contribute to the development of diabetes including obesity, physical inactivity, and poor diet. Hispanic adults are more likely to be affected by these risk behaviors compared to their White counterparts. In addition, increased diabetes prevalence and risk is seen in rural communities compared to urban communities. The landmark Diabetes Prevention Program (DPP) has shown success in preventing diabetes through diet and exercise across populations. Cultural adaptations to the DPP for Spanish- speaking adults have also shown success in weight loss to prevent diabetes. However, there remains significant difficulties in implementing these programs in rural communities due to access and resource availability. Given the diabetes health disparities seen in Hispanics in conjunction with rural health barriers, the development of a culturally tailored digital diabetes prevention program for rural Hispanics is warranted. The purpose of this project is to develop a mobile web-based diabetes prevention program for Hispanic adults living in rural communities. While the program will be internet- based, the contents and functions of the program will be optimized for both Android and IOS smartphones and other mobile devices. To address lower literacy levels, text will be minimized and easy to understand diagrams and simple navigation features will be used. The program will be media rich, including a program ?coach? and testimonials of real-life individuals discussing their experiences with diabetes prevention and weight loss. The program will also include interactive applications and games, videos of cooking demonstrations, and exercise videos. In Phase I, with input from three focus groups and our expert consultants, ISA staff will develop and pilot test STEPS: Small Changes to Diabetes Prevention, a prototype diabetes prevention program for Hispanic rural adults. Participants will be recruited form Community Action Corporation of South Texas (CACOST) and focus groups will review and discuss program content and components. ISA staff and the Redmon Group will develop the prototype of the eight-module program, fully developing the ?Welcome to STEPS?, ?Eat Well?, and ?Move Often? modules. Following development and expert review of the prototype, 24 adults age 25 years and older, also recruited from CACOST, will be asked to review and rate both the prototype and comparison Centers for Disease Control and Prevention Hispanic adapted diabetes prevention materials. To advance to Phase II, the prototype will have to receive average ratings of 3.5 or higher on a five-point scale, and it will also have to be rated as preferable to the comparison materials on 80% of the rating dimensions. We believe that feasibility and appeal of program concept will be achieved using these two rigorous criteria.