Mobile Approaches to Promote Moderate to Vigorous Physical Activity in Type 1 Diabetes

Type 1 Diabetes (T1D) affects ~1 million American adults and increases the risk of mortality attributable to cardiovascular disease. Interventions for T1D address glycemic control but not overall cardiovascular risk. Moderate-to-vigorous physical activity (MVPA) interventions could provide a novel solution if they could innovatively address the diabetes management and psychosocial challenges around MVPA posed by T1D. Continuous glucose monitoring (CGM) can capture the glycemic impact of exercise on type 1 diabetes (T1D) management, but evidence-based interventions to translate CGM feedback into sustainable adherence to exercise-related behaviors are lacking. Our human-delivered pilot intervention provided adults with T1D access to MVPA videos and monthly client-centered discussions of their CGM and MVPA data with an MVPA coach. Participants said these improved MVPA management behavioral skills and motivation transiently, but stated a need for more frequent and sustained contact, which will require informatics-based automated tools that the present research program will develop. The program represents stages 0-2 of the NIH intervention development model: basic science (informatics analysis of prior-collected data), intervention generation, refinement, modification, adaptation (qualitative evaluation of user perception and receptivity to alpha versions of the tools, modifications according to their feedback), and efficacy testing (clinical trial of beta version of the tool). The expected outcome is a novel mobile intervention tool that leverages cutting edge informatics to address low MVPA levels and cardiovascular-related sequalae in adults with T1D. Aim 1 (informatics). Apply 3 informatics methods to previous pilot data to test their utility for a math-based automated tool for T1D MVPA support. Aim 2 (alpha testing). Construct alpha version MOVE-CGM v2.0 and deliver to a new cohort of previously sedentary people with T1D for 4-week field-test. Aim 3 (beta testing). Construct beta version MOVE-CGM v2.1 and evaluate its efficacy to improve health outcomes for previously sedentary people with T1D. Datasets are: Aim 1: Coding scripts and raw datasets Aim 2: thematic codebook and data reduction tables of interview transcripts Aim 3: database of outcome measures, raw exports of sensor data