Abstract
Introduction: Filipino Americans have the highest prevalence of obesity and type 2 diabetes (T2D) compared to Asian American subgroups placing them at high risk for cardiometabolic disease. Effective interventions are needed to reduce these health disparities. Mobile health (mHealth) weight loss lifestyle interventions have been effective in reducing cardiometabolic risks, but are untested among Filipinos, particularly with T2D. As prolific users of digital technology, Filipinos are ideal candidates for mHealth lifestyle interventions. Therefore, we conducted the PilAm Go4Health intervention study - a culturally adapted weight loss lifestyle intervention using mobile technology to reduce cardiometabolic risks among Filipinos with T2D. Objective: To demonstrate intervention feasibility and potential efficacy. Hypothesis: 1) participant retention rate will be greater than 80%; 2) Compared to the control, intervention group will have significantly greater reduction in: % weight loss, waist circumference, fasting plasma glucose, and HbA1; and greater increase in step-counts. Methods: Two-arm (intervention +active control groups) RCT compared a 3-month intervention (Fitbit accelerometer +mHealth app/diary +Facebook group) and control (Fitbit accelerometer). N=45 overweight Filipino adults with T2D were recruited from Northern California communities. Between group differences from baseline to 3-months were analyzed using: 1) multilevel regression for within-person change in weight and step-counts using a nonparametric bias-corrected bootstrapped 95% CI for the multilevel models, and 2) T-tests, ANOVA for waist circumference, fasting plasma glucose, and HbA1c (significance =p<0.05, 2-sided). Cohen’s d was used for effect size analyses. Results: Randomized N=45 Filipinos (intervention =22 and control =23). Mean age was 58±10 years, 62% women, and retention rate=100%. There was significantly greater reduction in the intervention group compared to the control for: % weight (2.3% greater decrease, d=0.46); waist circumference (-2.68cm; d= 0.88); and fasting plasma glucose (-18.52mg/dl; d= -0.86). HbA1c group difference was not significant (-0.34%; p< 0.19). Step-counts significantly increased in the intervention group compared to control (3432 steps at endpoint; d=1.44). Conclusion: PilAm Go4Health intervention demonstrated excellent feasibility in recruitment and retention, and potential efficacy for reducing cardiometabolic risks in Filipinos with T2D. Results warrant further testing of this lifestyle intervention that may support translation to other at-risk diverse populations living with T2D.
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