Engaging Hispanic Adolescents with Type 2 Diabetes or Obesity in Personalized Exercise

The prevalence of obesity in Hispanic youth (21.9%; Ogden and Flegal, 2015) is the highest of all racial and ethnic groups, increasing their odds for the development of type 2 diabetes (T2D). The purpose of this secondary analysis of a larger trial of a 16-week personalized exercise intervention was to examine differences in exercise adherence and baseline perceptions of benefits and barriers to exercise, exercise self-efficacy and family support to exercise in Hispanic adolescents diagnosed with T2D or obesity. Changes in body mass index, waist circumference, glycosylated hemoglobin (HbA_1c), homeostatic model for insulin resistance (HOMA-IR), lipid profile, cardiorespiratory fitness, blood pressure and perception of health were also examined following the intervention. There were 21 adolescents enrolled in the study, 13 with T2D (3 males, 10 females) and 8 who were obese (3 males, 5 females). The personalized programs were based upon individual adolescent choices to promote moderate to vigorous activity (MVPA) and included gym memberships, dance videos, biking, basketball, softball and walking. Adolescents wore the Actigraph^TM accelerometer (model GT1M, Pensacola, FL) for tracking exercise throughout the intervention. The completion rate was 88% vs. 59% (67% overall) for obese vs. T2D, with obese adolescents engaging in higher duration of MVPA compared to those with T2D (mean 46.4 ± 33.8 vs. 36.3 ± 16.0 min/day, NS). Perceptions of family support for exercise were associated with benefits of exercise (r = .50, p = .021); barriers to exercise were associated with less MVPA (r = - .56, p = .017). Barriers were significantly higher in those with T2D (p = .01). Despite not meeting recommended activity guidelines, perceptions of health improved for all completing the intervention (p = .01). Future efforts for engaging Hispanic adolescents in regular exercise are warranted to delay the onset of T2D and the development of poor outcomes particularly for those already diagnosed with T2D.