A Feasible and Efficacious Mobile-Phone Based Lifestyle Intervention for Filipino Americans with Type 2 Diabetes: Randomized Controlled Trial.
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BACKGROUND Filipino Americans have a high prevalence of obesity type 2 diabetes T2D and cardiovascular disease compared with other Asian American subgroups and non Hispanic whites Mobile health mHealth weight loss interventions can reduce chronic disease risks but these are untested in Filipino Americans with T2D OBJECTIVE The objective of this study was to assess feasibility and potential efficacy of a pilot randomized controlled trial RCT of a culturally adapted mHealth weight loss lifestyle intervention Pilipino Americans Go4Health PilAm Go4Health for overweight Filipino Americans with T2D METHODS This was a 2 arm pilot RCT of the 3 month PilAm Go4Health intervention phase 1 with an active waitlist control and 3 month follow up phase 2 The waitlist control received the PilAm Go4Health in phase 2 whereas the intervention group transitioned to the 3 month follow up PilAm Go4Health incorporated a Fitbit accelerometer mobile app with diary for health behavior tracking steps food calories and weight and social media Facebook for virtual social support including 7 in person monthly meetings Filipino American adults 18 years with T2D were recruited from Northern California Feasibility was measured by rates of recruitment engagement and retention Multilevel regression analyses assessed within and between group differences for the secondary outcome of percent weight change and other outcomes of weight kg body mass index BMI waist circumference fasting plasma glucose HbA1c and steps RESULTS A total of 45 Filipino American adults were enrolled and randomized Mean age was 58 SD 10 years 62 28 45 were women and mean BMI was 30 1 SD 4 6 Participant retention and study completion were 100 with both the intervention and waitlist group achieving near perfect attendance at all 7 intervention office visits Groups receiving the PilAm Go4Health in phase 1 intervention group and phase 2 waitlist group had significantly greater weight loss 2 6 3 9 to 1 4 and 3 3 1 8 to 4 8 respectively compared with the nonintervention group resulting in a moderate to small effect sizes d 0 53 and 0 37 respectively In phase 1 18 4 22 of the intervention group achieved a 5 weight loss whereas 82 18 22 maintained or lost 2 to 5 of their weight and continued to maintain this weight loss in the 3 month follow up Other health outcomes including waist circumference BMI and step counts improved when each arm received the PilAm Go4Health but the fasting glucose and HbA1c outcomes were mixed CONCLUSIONS The PilAm Go4Health was feasible and demonstrated potential efficacy in reducing diabetes risks in overweight Filipino Americans with T2D This study supports the use of mHealth and other promising intervention strategies to reduce obesity and diabetes risks in Filipino Americans Further testing in a full scale RCT is warranted These findings may support intervention translation to reduce diabetes risks in other at risk diverse populations TRIAL REGISTRATION Clinicaltrials gov NCT02290184 https clinicaltrials gov ct2 show NCT02290184 Archived by WebCite at http www webcitation org 6vDfrvIPp