PilAm Go4Health Weight Loss Program to Prevent Heart Disease

Not Applicable

Completed

Interventions: Behavioral: PilAm Go4Health Weight-loss Program
Behavioral: Active Control

Brief Summary: This is a pilot randomized controlled trial intervention to improve lifestyle behaviors (physical activity and health diet) for Filipino Americans with type 2 diabetes on metformin. If the PilAm Go4Health intervention demonstrates potential efficacy, it may identify effective intervention strategies to significantly reduce risks for heart disease risks (i.e., metabolic syndrome) in Filipino Americans.

Detailed Description: Filipino Americans are the second largest Asian population and fastest growing racial group in the United States. They have one of the highest rates of insulin resistance (type 2 diabetes = T2DM) and central obesity (fat distributions primarily in the abdominal region). T2DM and central obesity are two of five major risk factors for metabolic syndrome that lead to cardiovascular disease and stroke. Key factors contributing to obesity and T2DM in Filipinos are their physical inactivity, and a diet high in fat and soda intake. However, there are very few research studies on improving health behaviors to reduce risks for metabolic syndrome in Filipino Americans. To help reduce the risk of developing metabolic syndrome in overweight/obese Filipino Americans with T2DM, the proposed project will test a culturally appropriate health behavior intervention program to reduce weight and waist circumference, through increasing physical activity, and lowering fat and sugar sweetened beverage intake. This intervention uses a mobile phone health app and social networking to encourage adherence to target health behaviors. The goals are to:

1. To assess feasibility and acceptability of the culturally appropriate PilAm Go4Health Weight Loss Program

2. To obtain preliminary estimates of the effect of the intervention on weight

3. To conduct post-program process evaluations too improve the intervention relevancy for the target population.

Recruitment & Eligibility

Inclusion Criteria

Self-identified as Filipino
Age > 18 years
BMI for Asians > 23 kg/m2
Physician diagnosed T2DM diabetes confirmed by clinical data (e.g. documentation of fasting blood glucose >126 mg/dL or a positive oral glucose tolerance test (OGTT) > 200 mg/dl, HbA1c > 6.5%)
On metformin for T2DM

waist circumference: men > 40 inches, women > 35 inches 6) Physically inactive - most leisure time spent without much physical activity 7) No cognitive impairment per the Mini-Cog test 8) has a mobile smart phone (iPhone 4s or above, or android phone) 9) English speaking. Only one member per household allowed to enroll in the study.

Exclusion Criteria

Uncontrolled T2DM
Glucose metabolism associated disease (Cushing's syndrome, Acromegaly, and Pheochromocytoma currently under treatment, chronic pancreatitis), 2) Thyroid disease - sub-optimally treated
Known medical conditions or other physical problems needing a special exercise program (e.g., prior myocardial infarction, history of angioplasty or angina, admission for hospital evaluation of chest pain, use of nitroglycerin for angina, chronic obstructive pulmonary disease, or uncontrolled hypertension)
Recent acute coronary syndrome, congestive heart failure
Currently participating in a lifestyle modification program
Planning a trip outside of the US during the 6-month study period
Known eating disorder
Planning a surgery in the next 7-months
Taking long-term antibiotics (including HIV-related agents), anti-tuberculosis agents (except isoniazid alone as prophylaxis), or prescription weight-loss drugs

Arm && Interventions

Group	Intervention	Description
Intervention - PilAm Go4Health Program	PilAm Go4Health Weight-loss Program	In the first 3 months this groups will start with the PilAm Go4Health Weight-loss Program lifestyle intervention. After 3 months this group will transition to a 3-month maintenance phase where they will continue to maintain the physical activity and healthy eating behaviors learned in the PilAm Go4Health Weight-loss Program lifestyle intervention and will complete the study for a total of 6 months.
Active control - pedometer only	Active Control	In the first 3 months this groups will start with a pedometer only. After 3 months, this group will transition to receive the PilAm Go4Health Weight-loss Program lifestyle intervention for the next 3 month and will complete the study for a total of 6 months

Primary Outcome Measures

Name	Time	Method
Feasibility for Participant Enrollment and Retention	Baseline to 6-months	Able to enroll at least 20 eligible participants per arm (measured by count), and retain at least 80% of enrolled participants in each arm

Secondary Outcome Measures

Name	Time	Method
Weight Change in Kilograms	Baseline to 3 months	weight change in kilograms over a 3 month period. Intervention group will have a significantly greater reduction in weight change compared to the active control from baseline to 3-months
Percent Change in Weight (kg) From Baseline and 3 Months	Baseline to 3 months	100 x change in weight (kg) at 3 months divided by weight (kg) at baseline. Intervention group will have a significantly greater reduction in % weight change compared to the active control from baseline to 3-months.
Change in Waist Circumference	baseline to 3 months	Change in waist circumference over time within groups