Targeted Upstream Prevention (T-UP): Engaging Vulnerable Students in Diabetes Prevention

Aim 1 - Design: Pre/post pilot trial of 100 participants (<1% of total number of eligible UCLA undergraduates). The investigators will randomize participants to the AYA-tailored DPP vs control based on a stratified, block (n=2) schema based on age [≤19/≥20] and sex [M/F]. All control participants will be offered the opportunity to participate in the AYA-tailored DPP in the following academic year (in the interest of equipoise).

Aim 1 - Participant Recruitment: All participants will be asked to complete a brief online intake form to assess eligibility and to collect preferred contact information. This form will further allow the investigators to prioritize recruitment efforts of those with identified food, financial, or stress-related vulnerability (per standard NCHA questions). After confirming eligibility, a trained research assistant (RA) will reach out to eligible participants to obtain informed consent and enroll them in the pilot trial.

Aim 1 - Tailored DPP Intervention: Once consented and enrolled, participants will be randomized into one of two cohorts, the first group will be enrolled in the tailored DPP for the immediate academic year while the second will be enrolled in a series of unrelated interventions in year 1 and offered the opportunity to participate in the AYA-tailored DPP for the following academic year. As social support is a key component of the program, participants will be organized into groups within their DPP cohort based on their student status (frosh/soph vs junior/senior) and/or place of residence (residence hall vs off-campus). The intervention will include 19 sessions (18 in-person and 1 on-demand) covering 24 DPP modules; each session is approximately an hour in length and will be moderated by a trained lifestyle coach. Lifestyle coaches are accessible, collaborative, and culturally competent diabetes care and education specialists trained and certified in the CDC's National DPP curriculum to provide effective guidance and support for program participants. The Lifestyle Coach's ability to support participants, provide guidance, and help groups work together effectively is essential for a successful lifestyle change program. Each group will meet regularly during the academic year, with six in-person sessions delivered per 10-week quarter (for each of three quarters) to allow for breaks during final exams and scheduled school recess(e.g., spring break). The interventions for the intervention participants will take place on UCLA campus. It will take place at the John Wooden Center, UCLA Teaching Kitchen, UCLA dining halls, UCLA sculpture garden, UCLA botanical garden, UCLA Arthur Ashe Student Health & Wellness Center, UCLA Glendon building, UCLA Murphy Hall, and other UCLA buildings. UC DPP has consistently been using some of these places to facilitate the program.

The control group will receive access to a study habits intervention (fall), alcohol use intervention (winter), and financial literacy intervention (spring). The control group will receive each intervention materials via e-mail for participants to review on their own time. The interventions for the control group will be remote. A research assistant will meet with control participants via Zoom to explain the intervention materials. The Zoom session will take approximately 1 hour. At the end of each session, participants will receive an email or text (depending on their preferred method of contact) with a unique link to a brief (~1 minute) REDCap survey to ascertain acceptability of the session. There will be three zoom sessions in total (one for each intervention).

The last acceptability survey of the Fall and Winter quarter for the intervention group (and the only acceptability survey for the control group) will ask about self-reported weight and physical activity. The investigators will send the last acceptability survey of the Fall and Winter quarter for the intervention group around the same time the investigators will send the only acceptability survey for the control group.