1827-LB: A Multilevel, mHealth-Based Culturally Tailored Diabetes Prevention Program for Chinese Immigrants—Preliminary Results from the INCLUDE Study

Objective: Despite well-established evidence supporting the efficacy of the Diabetes Prevention Program (DPP), dissemination of the DPP to underserved communities is suboptimal. INCLUDE is an ADA-funded three year study to assess a multi-level mHealth intervention to provide a culturally tailored, language-concordant DPP and address food insecurity among Chinese immigrants. Here, we report feasibility data from Year 1 of the INCLUDE study.

Methods: INCLUDE is a randomized clinical trial with Chinese American adults with BMI ≥ 23 at risk for diabetes with a planned sample size of 150 and intervention duration of 3 months. In Year 1, 75 patients were randomized to intervention (n=38) or control (n=37) groups. Intervention participants received 2-3 culturally adapted in-language DPP videos a week for 12 weeks, biweekly calls from trained bilingual (Mandarin Chinese) study staff, and culturally appropriate produce weekly for 10 weeks at a local farm. The primary aim of the study is to evaluate weight loss at 3 and 6 months. This report presents feasibility data for intervention participants.

Results: Intervention participants (n=38, median age 48.5 [IQR 37.5-61.3]) were mostly female (84%), born outside the US (97%), and limited English proficient (82%). Participants reported an average video watch rate of 89% (SD 5.0%), a fresh produce pickup rate of 57% (SD 7.7%), a biweekly call completion rate of 81% (SD 15.5%). Overall retention rate was 95% at 3 months. Most (86%) participants agreed or strongly agreed that the program motivated weight loss, and all agreed or strongly agreed that the program increased confidence to prevent diabetes.

Conclusion: Initial results demonstrate feasibility of a culturally adapted multi-level DPP intervention for underserved Chinese immigrants. Additional research with a longer duration and larger sample size is warranted to examine intervention effectiveness with adequate power.