Diabetes Prevention for Hispanics Residing in Rural Communities: A Mobile Web-based Approach

AbstractDiabetes is a public health threat and is theth leading cause of death among Hispanics in the United StatesThere are several risk behaviors that contribute to the development of diabetes including obesityphysical inactivityand poor dietHispanic adults are more likely to be affected by these risk behaviors compared to their White counterpartsIn additionincreased diabetes prevalence and risk is seen in rural communities compared to urban communitiesThe landmark Diabetes Prevention ProgramDPPhas shown success in preventing diabetes through diet and exercise across populationsCultural adaptations to the DPP for Spanishspeaking adults have also shown success in weight loss to prevent diabetesHoweverthere remains significant difficulties in implementing these programs in rural communities due to access and resource availabilityGiven the diabetes health disparities seen in Hispanics in conjunction with rural health barriersthe development of a culturally tailored digital diabetes prevention program for rural Hispanics is warrantedThe purpose of this project is to develop a mobile web based diabetes prevention program for Hispanic adults living in rural communitiesWhile the program will be internetbasedthe contents and functions of the program will be optimized for both Android and IOS smartphones and other mobile devicesTo address lower literacy levelstext will be minimized and easy to understand diagrams and simple navigation features will be usedThe program will be media richincluding a programcoachand testimonials of real life individuals discussing their experiences with diabetes prevention and weight lossThe program will also include interactive applications and gamesvideos of cooking demonstrationsand exercise videosIn Phase Iwith input from three focus groups and our expert consultantsISA staff will develop and pilot test STEPSSmall Changes to Diabetes Preventiona prototype diabetes prevention program for Hispanic rural adultsParticipants will be recruited form Community Action Corporation of South TexasCACOSTand focus groups will review and discuss program content and componentsISA staff and the Redmon Group will develop the prototype of the eight module programfully developing theWelcome to STEPSEat WellandMove OftenmodulesFollowing development and expert review of the prototypeadults ageyears and olderalso recruited from CACOSTwill be asked to review and rate both the prototype and comparison Centers for Disease Control and Prevention Hispanic adapted diabetes prevention materialsTo advance to Phase IIthe prototype will have to receive average ratings ofor higher on a five point scaleand it will also have to be rated as preferable to the comparison materials onof the rating dimensionsWe believe that feasibility and appeal of program concept will be achieved using these two rigorous criteria Project Narrative This project aims to develop a web based program focusing on prevention of diabetes in Hispanic populations residing in rural communitiesThe programSTEPSwill deliver culturally tailored information to users following assessments of their needs and personal situationThe program will be designed to provide users with the informationskillsand tools needed to promote health and reduce risk for the development of diabetesMaterials will be multi modal in formate gnarration by a programcoachculturally appropriate visualsgraphicsinteractive assessments with feedbackand tailoring of informationIt will also incorporate a responsive web design allowing access from a range of personal devices with optimization for mobile phonesThe goal of the program will be to promote self management of diet and physical activity and minimize risks associated with diabetesUpon successful development and testing of the prototype a Phase II application will be submitted