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Principal Investigator: Erica Soltero
Organization: BAYLOR COLLEGE OF MEDICINE
Fiscal Year: 2024
Award: $66,012
Funding agency: National Institute of Diabetes and Digestive and Kidney Diseases
Project Summary
Hispanic adolescents are disproportionately burdened by type 2 diabetes (T2D) and social determinants of health
(SDoH), which can serve as barriers to behavior change and participation in disease prevention efforts.
Telehealth is a potentially effective approach for delivering disease prevention programs in vulnerable
communities as it reduces the burden of some SDoH like transportation, childcare needs, and parent work
schedules. However, there are no theory- or evidence-based telehealth T2D prevention programs for Hispanic
youth. The goal of this career development award is to assist Dr. Erica Soltero in her long-term goal of becoming
an independent investigator designing and implementing T2D prevention interventions among high-risk pediatric
populations impacted by SDoH. Dr. Soltero’s short-term goals include gaining expertise in the use of mixed-
methods, the Self-Determination Theory (SDT), and development of technology-based interventions. In
collaboration with her multidisciplinary mentorship team, she has developed a training plan to reach these goals
via coursework, workshops, scientific meetings, and mentored research. The purpose of this study is to adapt
Everly Little Step Counts (ELSC), an evidence-based, culturally grounded T2D prevention program, for delivery
via telehealth and test the feasibility and acceptability of the adapted telehealth intervention. While telehealth is
more suited for remotely delivering nutrition education, other technology-based tools are needed to remotely
promote physical activity (PA). Thus, we will adapt and integrate our previously tested intervention that uses
activity trackers (i.e. Fitbit) and text-messages grounded in the SDT to promote PA into the telehealth program.
To ensure that all technology-based components are feasible and considerate of SDoH, we will use a mixed-
methods approach across three iterative phases to engage Hispanic adolescents (14-16 years; N=24) and their
parents (N=24) in the adaptation process. Once the ELSC-telehealth program is developed, a new sample of
Hispanic adolescents (14-16 years; N=40) with obesity (BMI%≥95th) will be recruited from community clinics
and randomized to the 12-week ELSC-telehealth intervention or usual care control group. Feasibility and
acceptability will be assessed using a priori feasibility criteria (e.g. recruitment, data collection, fidelity) and exit
interviews. We will examine the preliminary efficacy of the intervention on PA and T2D risk outcomes (fasting
glucose, insulin, insulin resistance and HbA1c). This proposal builds on the investigative team’s previous work
in T2D prevention, activity trackers, and text messaging to develop a telehealth delivered T2D prevention
program with great potential for reaching and engaging Hispanic youth. This study will advance the science on
telehealth as a disease-prevention tool among high-risk youth impacted by SDoH. Completion of the proposed
training and research will provide Dr. Soltero with the skills, research experience, professional development, and
scholarly products needed to apply for R01 funding and transition to a successful, independent scientist.
Terms: <21+ years old><Accelerometer><Address><Adolescent><Adolescent Youth><Adult><Adult Human><Adult-Onset Diabetes Mellitus><Age><Area><Award><BMI><BMI percentile><BMI z-score><Body Weight decreased><Body mass index><COVID-19><CV-19><Career Development Awards><Career Development Awards and Programs><Career Development Programs K-Series><Cell Phone><Cellular Phone><Cellular Telephone><Centers for Medicare and Medicaid Services><Child Care><Childhood><Collaborations><Communication><Coronavirus Infectious Disease 2019><Cost of Illness><Data Collection><Development><Devices><Diabetes Mellitus><Diabetes prevention><Disease><Disease Costs><Disease Outcome><Disorder><Disparities><Disparity><Education><Educational aspects><Educational workshop><Effectiveness><Ensure><Exhibits><Family><Feedback><Focus Groups><Foundations><Funding><Glycohemoglobin A><Glycosylated hemoglobin A><Goals><Hb A1><Hb A1a+b><Hb A1c><HbA1><HbA1c><Health Care Financing Administration><Health Instruction><Health Tutoring><Health behavior><Health behavior and outcomes><Health education><Healthcare><Healthcare Delivery><Hemoglobin A(1)><Hispanic><Home><Humulin R><Insulin><Insulin Resistance><Insurance Coverage><Insurance Status><Internet><Intervention><Intervention Strategies><Interview><Investigators><K-Awards><K-Series Research Career Programs><Ketosis-Resistant Diabetes Mellitus><Life Expectancy><Maturity-Onset Diabetes Mellitus><Mentors><Mentorship><Methods><Minority><Mobile Phones><NIDDM><Non-Hispanic><Non-Insulin Dependent Diabetes><Non-Insulin-Dependent Diabetes Mellitus><Nonhispanic><Noninsulin Dependent Diabetes><Noninsulin Dependent Diabetes Mellitus><Not Hispanic or Latino><Novolin R><Obesity><Outcome><Parents><Participant><Personal awareness><Persons><Phase><Physical activity><Population><Prediabetes><Prediabetes syndrome><Prediabetic State><Preventative intervention><Preventative strategy><Prevention><Prevention program><Prevention strategy><Preventive strategy><Process><Puericulture><QOL><Quality of life><Quetelet index><Randomized><Regular Insulin><Reporting><Research><Research Career Program><Research Personnel><Researchers><Sampling><Schedule><Science><Scientist><Self Determination><Self Perception><Self image><Self view><Services><Sickness Cost><Slow-Onset Diabetes Mellitus><Stable Diabetes Mellitus><Survey Instrument><Surveys><T2 DM><T2D><T2DM><Technology><Telecommunications><Testing><Text Messaging><Training><Transportation><Treatment Efficacy><Type 2 Diabetes Mellitus><Type 2 diabetes><Type II Diabetes Mellitus><Type II diabetes><United States Centers for Medicare and Medicaid Services><United States Health Care Financing Administration><WWW><Weight Loss><Weight Reduction><Work><Workshop><Youth><Youth 10-21><accelerometry><acceptability and feasibility><activity monitor><activity tracker><adiposity><adolescent minority><adult onset diabetes><adulthood><ages><behavior change><body weight loss><care as usual><community clinic><community engaged approach><community engaged approaches><community engaged strategies><community engaged strategy><community partnered approach><community partnered strategy><coronavirus disease 2019><coronavirus disease-19><coronavirus infectious disease-19><corpulence><delivered remotely><design><designing><developmental><diabetes><diabetes prevention program><diabetes risk><diet education><digital><disease prevention><disorder prevention><evidence base><experience><fasting glucose><feasibility testing><field based data><field learning><field study><field test><fitbit><health and care delivery><health care><health care delivery><health delivery systems><health disparity community><health disparity group><health disparity populations><health related behavior><health services delivery><hemoglobin A1c><high risk><homes><iPhone><improved><innovative technologies><insulin resistant><insulin sensitivity><insulin tolerance><intervention delivery><intervention efficacy><intervention for prevention><interventional strategy><juvenile><juvenile human><ketosis resistant diabetes><life style intervention><life-time risk><lifestyle intervention><lifetime risk><maturity onset diabetes><meeting><meetings><minority children><minority youth><multidisciplinary><novel><nutrition><nutrition education><parent><pediatric><pediatric minority><pre-diabetes><pre-diabetic><prediabetic><prevent><preventing><prevention intervention><preventional intervention strategy><preventive intervention><programs><randomisation><randomization><randomly assigned><recruit><remote delivery><self awareness><self knowledge><short message service><skills><smart phone><smartphone><social determinants><social health determinants><sociodeterminant><tech development><technology development><technology intervention><technology-based interventions><technology-enabled interventions><technology-focused interventions><telehealth><telehealth care><telehealthcare><texting><theories><therapeutic efficacy><therapy efficacy><tool><treatment as usual><type 2 DM><type II DM><type two diabetes><usability><usual care><usual care arm><usual care control group><vulnerable community><web><world wide web><wt-loss><young minority>