Active You: Feasibility of a Unique Physical Activity Program to Prevent Diabetes and Heart Disease
Condition: Cardiovascular Risk Factor; Prediabetes; Overweight and Obesity; Sedentary Behavior
MeSH terms: Overweight
Study type: Interventional

Summary: 
      Individuals who are overweight/obese are more vulnerable to type 2 diabetes (T2D). Current
      evidence suggests that PA, even without dietary prescription, can be efficacious in
      preventing T2D. Yet most Americans, especially those who are overweight/obese, are not
      physically active. Socioenvironmental barriers to physical activity (PA) such as body image
      concerns and limited access to fitness facilities contribute to the low levels of PA observed
      in overweight/obese adults. Web-based PA programs have been developed to address these
      barriers, but the outcomes have been marginal. Qualitative studies suggest that individuals
      who are overweight/obese prefer PA programs that feature people they can relate to especially
      in body size, fitness status and age. Previously, the investigators have included these
      preferences in a technology-based Physical Activity for The Heart (PATH) intervention that
      leverages open source platforms, such as YouTube, to promote PA in any setting. In this
      application, the investigators propose to test the feasibility and preliminary efficacy of
      PATH in promoting PA and reducing cardiometabolic risk in adults who are overweight/obese and
      at high risk of diabetes. In Aim 1 the investigators will conduct a 12-week randomized
      clinical trial including 52 adults who are overweight/obese and at high risk of diabetes to
      assess the feasibility and acceptability of PATH. In Aim 2 investigators will examine the
      trend in PA and cardiometabolic risk change from baseline to post-intervention. This approach
      is innovative because it leverages open source technologies to provide low-cost,
      action-oriented PA resources that match the preferences of adults who are overweight/obese.
      This contribution will be significant because PATH could offer a convenient, enjoyable and
      scalable program that features "similar others" to promote PA in overweight/obese adults at
      high risk of diabetes.
    

Detailed description: 
      Currently, only 20% of American adults attain the minimum 150 mins/week of MVPA recommended
      by the 2018 PA Guidelines for Americans. The low levels of PA are associated with the rising
      prevalence of obesity and T2D. Individuals who are overweight/obese need a higher volume of
      PA (~200-300 mins of weekly MVPA) to mitigate cardiometabolic risk, but they face complex
      multifaceted barriers that decrease their engagement in PA. Multiple studies exploring
      barriers and facilitators of PA among these individuals have emphasized the need for
      interventions that address weight-related impediments (e.g., stigma, fitness) and
      environmental barriers such as limited access to fitness facilities. In the last 2 decades
      web-based PA programs have been developed to address these barriers and to provide more
      interactive resources than those typically mailed to participants in home-based programs. In
      a recent analytic review of web-based PA interventions, 44 out of 72 studies reported
      significant increases in PA. However, 10 out of 13 studies focusing on adults who are
      overweight/obese reported no significant improvements in PA. Most of these studies employed
      interventions that are typically used in the general population (e.g., learning modules,
      email feedback, chat sessions) without adapting them to address barriers that are unique to
      individuals who are overweight/obese. Formative studies and social cognitive theory supports
      the need for PA interventions that feature individuals who are overweight/obese engaging in
      PA to motivate action and demonstrate success. In recent years, Internet ubiquity and
      creation of YouTube has enabled fitness experts across the globe to develop and share a wide
      variety of high quality workout videos designed to make PA convenient and enjoyable for all
      demographics. The investigators leveraged these resources and the aforementioned preference
      data to design an action-oriented PATH program tailored for individuals who are
      overweight/obese. The workout videos curated on PATH website were vetted by the study team
      and stakeholders. The investigators contribution in this project is expected to be a detailed
      understanding of how open sourced resources in interventions like PATH are received and
      utilized by overweight/obese adults.
    

Intervention name(s): The Physical Activity for The Heart (PATH) intervention; Be Active Your Way Booklet
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The web-based Physical Activity for The Heart (PATH) intervention leverages openly accessible platforms, such as YouTube, to proffer workout videos that match the participants preferences. Currently, PATH includes over 90 workout videos vetted by a team of experts and curated on the PATH website in 3 controlled levels of intensity (beginner, intermediate, proficient) to foster gradual progression from low to high intensity PA in accordance with the FITT-VP (frequency, intensity, time, type, volume, progression) principle.; Be Active Your Way booklet was developed by the Centers for Disease Control (CDC) to help individuals integrate PA in their daily lives. It simply encourages individuals to increase their PA gradually and gives them examples of things that they can do.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: We will randomize 52 participants to either the PATH treatment group or wait-list control group.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Physical activity; Web-based; YouTube