アクティブなあなた: ウォーキング、ダンス、腹筋を引き締めて糖尿病のリスクを軽減しましょう

実験的：PATH介入

活動性が不十分で肥満のある成人は、PATH 介入に割り当てられます。

行動：PATH介入

PATH 介入は、参加者がライフスタイルと PA の習慣を変えるよう導き、PA の段階的な改善をサポートします。 ヘルス コーチは、参加者に PATH Web サイトへのアクセスと、PATH に含まれるリソースの使用方法の指示を提供します。 ヘルスコーチは月に 2 回、各参加者とリモートで会議を行い、MVPA の向上に向けたカスタマイズされた計画を作成します。 PATH レベルを割り当てた後、ヘルス コーチは各参加者が毎週の PA 目標を選択できるようにガイドし、週 3 ～ 5 日の定期的な運動頻度を確立する計画をゆっくりと始めるのを支援します。

参加者は、ウォーキング、ダンス、腹部コアトレーニングを組み合わせて、2 週間ごとにベースライン PA に少なくとも 10 分間の MVPA を追加します。 リモート コーチは、各参加者に少なくとも 2 日間の有酸素トレーニング (ウォーキングまたはダンス セッション) と 1 日間の腹部コア トレーニングに取り組むよう奨励します。

他の名前：

• 道

行動：食育

研究チームは食事の質を調査し、食事の質を促進するために厳選された教育コンテンツをすべての研究参加者に提供します。 参加者の負担を最小限に抑えるため、介入群と​​対照群の両方に、新しい食事の構成要素を記載した簡単な PDF が記載された電子メールが 4 週間ごとに送信されます。

デバイス：身体活動トラッカー

参加者は、24 時間装着プロトコルを使用して、研究期間中ずっと利き手と反対側に ScanWatch トラッカーを装着するように求められます。

他の名前：

• スキャンウォッチ

他の：対照群

肥満で活動性が不十分な成人は、注意制御グループに割り当てられます。

行動：食育

研究チームは食事の質を調査し、食事の質を促進するために厳選された教育コンテンツをすべての研究参加者に提供します。 参加者の負担を最小限に抑えるため、介入群と​​対照群の両方に、新しい食事の構成要素を記載した簡単な PDF が記載された電子メールが 4 週間ごとに送信されます。

デバイス：身体活動トラッカー

参加者は、24 時間装着プロトコルを使用して、研究期間中ずっと利き手と反対側に ScanWatch トラッカーを装着するように求められます。

他の名前：

• スキャンウォッチ

行動：対照群

研究スタッフは各コントロールグループ参加者とZoomミーティングを開き、配布資料「Be Active Your Way」を使用し、ScanWatchを使用してPAを自己モニタリングするようアドバイスを受けます。 さらに、グループには、一般的な健康トピック (ドライアイなど) や最新の医療ニュース (ワクチンなど) に焦点を当てた専門用語のない Web サイト、www.health.com も紹介されます。 対照参加者は 2 週間ごとに研究スタッフと Zoom で会い、研究の進捗状況を確認することで、グループ間の連絡を可能な限り同様に保ちます。

Participants Enrolled Within 4 Months of Study Opening

Number of participants enrolled within 4 months after the study opened to enrollment.

Number of Participants Retained in Each Group

Number of participants (Retention rate) retained in each group at 12 weeks after enrollment

The System Usability Scale

The System Usability Scale (SUS) is an industry-standard, 10-item questionnaire used to evaluate the perceived usability of a product, system, or service. It provides a quick, reliable, and quantifiable measure of ease of use and user satisfaction. Users rate their level of agreement or disagreement with 10 statements using a 5-point Likert scale (1 = Strongly Disagree, 5 = Strongly Agree). Responses are converted and summed according to standard SUS scoring and transformed to a total score ranging from 0 to 100. The average score is about 68. A score above 68 is considered above average/good; a score below 68 is below average. Acceptability Ranges: Scores above 70 are typically considered "Acceptable," while scores below 50 usually indicate a system with poorer usability that needs to be redesigned.

Participants' Satisfaction of Protocol Procedures (Acceptability)

Participant satisfaction was assessed using an end-of-study user experience survey. Participants rated navigation ease (extremely easy/very easy) and overall satisfaction with the content and messaging.

Navigation ease (extremely/very easy) Cultural appropriateness (very/somewhat appropriate) Workout access (extremely/very easy) Text reminders helpful (extremely/very helpful)

Participants' Engagement

Participants who visited the PATH platform at least twice weekly.

Adiponectin and Leptin

Adiponectin is a hormone released by adipose tissue and other body tissues, which assists with insulin sensitivity and reduces inflammation. Normal ranges vary depending on sex and BMI and in general lower levels are associated with health conditions of obesity, Type 2 diabetes, and atherosclerosis. Adiponectin and leptin will be collected via dry blood spot kits. A significant increase in adiponectin and decline in leptin, and T2D risk score will indicate improved adipocytokine and cardiometabolic risk profile and vice versa.

Monocyte Chemoattractant Protein-1 (MCP-1)

MCP-1 is one of the key chemokines that regulate the migration and infiltration of monocytes/macrophages. MCP-1 will be collected via dry blood spot kits. A significant decline in MCP-1 will indicate improved adipocytokine and cardiometabolic risk profile and vice versa.

Proinflammatory Cytokines

Proinflammatory cytokines: tumor necrosis factor Alpha (TNF-α), Interleukin-1 beta (IL1β), and Interleukin-6 (IL6), and CRP will be collected via dry blood spot kits. A significant decline in TNF-α, IL1β, and IL6 will indicate improved adipocytokine and cardiometabolic risk profile, and vice versa.

Insulin Levels

Collected via Dried Blood Spot (DBS) kits

Type 2 Diabetes (T2D) Risk Score

The calculation of the American Diabetes Association (ADA) T2D risk score includes covariates such as age, sex, family history of diabetes, history of high blood pressure (BP), body mass index, and PA regimen (total score of 0-11). Scores ≥5 should be formally screened for diabetes per ADA guidelines.

Change in Exercise Self-efficacy Questionnaire (EXSE)

EXSE Scale assesses an individual's beliefs in their ability to continue exercising on a three-time-per-week basis at moderate intensities for 40+ minutes per session in the future. For each item, participants indicate their confidence to execute the behavior on a 100-point percentage scale comprised of 10-point increments, ranging from 0% (not at all confident) to 100% (highly confident). The total strength for each measure of self-efficacy is then calculated by summing the confidence ratings and dividing by the total number of items in the scale, resulting in a maximum possible efficacy score of 100.

Change in Exercise Self-regulation

Exercise Self-regulation involves skills for planning, organizing, and managing exercise activities. will be measured by the Exercise Goal-Setting Scale (EGS) and the Exercise Planning and Scheduling Scale (EPS). Participants will rate 10 EGS items and 10 EPS items on a 5-point scale ranging from 1 (does not describe) to 5 (describes completely). Higher levels of self-regulatory skills, such as goal-setting, self-monitoring, planning, and problem-solving, may result in higher levels of PA.

Change in the Physical Activity (PA) Enjoyment

The Physical Activity Enjoyment Scale is an 18-item scale that assesses enjoyment of physical activity by asking participants to rate "how do you feel at the moment about the physical activity you have been doing" using a 7- point bipolar Likert scale, from 1 (I enjoy it) to 7 (I hate).

Change in the Social Support Questionnaire (SSQ) Score

SSQ has two-part answer questions. It asks to list up to 9 people who provide support that meets the criteria stated in the question. The support persons are listed by initials and relationship to the participant. Participants then rate their satisfaction (1 - very dissatisfied to 6 - very satisfied) with the support of each person stated in the first part. The support score (SSQN) is calculated by the average of the individual scores across the 27 items. A high score indicates more optimism about life than a low score. Low SSQ scores have a higher prevalence of negative life events and illness.

Add the total number of people for all 27 items. (Max. is 243). Divide by 27 for the average item score=SSQ Number Score (SSQN) Add the total satisfaction scores for all 27 items. (Max is 162). Divide by 27 for the average item score=SSQ Satisfaction score (SSQS) Average the above for the total number of family members - this results in the SSQ family score

Change in the Outcome Expectations for Exercise Scale Questionnaires.

The Outcome Expectations for Exercise Scale (OEE) contains 9 statements rated by participants using a 5-point Likert scale from 1 "Strongly Disagree" to 5 "Strongly Agree". The OEE was made primarily to study older adults with low expectations of the effects of exercise.