활동적인 당신: 당뇨병 위험을 줄이기 위해 걷고, 춤추고, 탄탄한 복근을 만드세요.

실험적: PATH 개입

활동량이 부족한 비만 성인은 PATH 개입에 배정됩니다.

행동: PATH 개입

PATH 개입은 PA의 점진적인 개선을 지원하기 위해 참가자의 생활 방식과 PA 습관을 바꾸도록 안내합니다. 건강 코치는 참가자에게 PATH 웹사이트에 대한 액세스 권한과 PATH에 포함된 리소스를 사용하는 방법에 대한 지침을 제공합니다. 건강 코치는 한 달에 두 번씩 각 참가자와 원격으로 만나 MVPA 증가에 맞춘 맞춤형 계획을 개발합니다. PATH 수준을 할당한 후 건강 코치는 각 참가자에게 주간 PA 목표를 선택하도록 안내하고 일주일에 3~5일의 규칙적인 운동 빈도를 설정하는 계획을 통해 천천히 시작하도록 돕습니다.

참가자는 걷기, 춤, 복부 코어 운동을 조합하여 2주마다 기본 PA에 최소 10분의 MVPA를 추가합니다. 원격 코치는 각 참가자에게 최소 2일의 유산소 운동(걷기 또는 댄스 세션)과 하루의 복부 코어 운동에 참여하도록 권장합니다.

다른 이름들:

• 길

행동: 식생활 교육

연구팀은 다이어트의 질을 조사하고 모든 연구 참가자에게 다이어트의 질을 향상시키기 위해 선별된 교육 콘텐츠를 제공할 것입니다. 참가자의 부담을 최소화하기 위해 중재군과 대조군 모두 4주마다 새로운 다이어트 구성 요소를 다루는 간략한 PDF가 포함된 이메일을 받게 됩니다.

장치: 신체 활동 추적기

참가자는 24시간 착용 프로토콜을 사용하여 전체 연구 기간 동안 주로 사용하지 않는 손에 ScanWatch 추적기를 착용해야 합니다.

다른 이름들:

• 스캔워치

다른: 컨트롤 그룹

활동량이 부족한 비만 성인을 주의력 통제 그룹에 배정합니다.

행동: 식생활 교육

연구팀은 다이어트의 질을 조사하고 모든 연구 참가자에게 다이어트의 질을 향상시키기 위해 선별된 교육 콘텐츠를 제공할 것입니다. 참가자의 부담을 최소화하기 위해 중재군과 대조군 모두 4주마다 새로운 다이어트 구성 요소를 다루는 간략한 PDF가 포함된 이메일을 받게 됩니다.

장치: 신체 활동 추적기

참가자는 24시간 착용 프로토콜을 사용하여 전체 연구 기간 동안 주로 사용하지 않는 손에 ScanWatch 추적기를 착용해야 합니다.

다른 이름들:

• 스캔워치

행동: 컨트롤 그룹

연구 직원은 각 통제 그룹 참가자와 Zoom 회의를 갖고 Be Active Your Way 유인물을 사용하고 ScanWatch를 사용하여 PA를 자체 모니터링하도록 조언받습니다. 또한 그룹은 일반적인 건강 주제(예: 안구 건조증)와 최신 의학 뉴스(예: 백신)에 초점을 맞춘 전문 용어 없는 웹사이트인 www.health.com에 소개될 것입니다. 2주마다 통제 참가자는 Zoom에서 연구 직원과 만나 연구 진행 상황을 검토하여 그룹 간의 접촉을 최대한 유사하게 유지합니다.

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.