Description
Inclusion Criteria:
- * Age: Lower age limit - 18 years, Upper age limit - NONE
- * Race/ethnicity: self-reported Latinx ethnicity
- * Sex: Female
- * Body mass index: ≥ 30 kg/m2
- * One or more metabolic risk factors as follows:
- * Fasting plasma glucose of 100 to 125 mg/dL or HbA1c of 5.7 to 6.4 if detected by a recent (within the past year), documented, blood-based diagnostic test in the Electronic Health Record (EHR) in the last year
- * Waist circumference \>40 inches in men and \>35 inches in women (≥35 inches in men and ≥31 inches in women, if of Asian descent) as measured by the study coordinator
- * Triglycerides \>150 mg/dL as documented in the EHR in the last year
- * High-density lipoprotein cholesterol (HDL-C) \<40 mg/dL in men and \<50 mg/dL in women as documented in the EHR in the last year
- * Systolic blood pressure \>120 mmHg or diastolic blood pressure \>80 mmHg as measured by study coordinator
- * Food insecurity: Defined as answering yes to one or both questions of the Hunger Vital Sign
- * PCP approval of patient contact for study screening
- * Able and willing to enroll and provide informed consent, i.e., to meet the time and data collection requirements of the study, be randomized to one of 2 study arms, participate for 24 months, and authorize extraction of relevant information from the EHR.
Exclusion Criteria:
- * Previous diagnosis of diabetes (other than during pregnancy) or diabetes documented in the EHR
- * Diagnosis of cancer (other than non-melanoma skin cancer) that is/was active or treated with radiation or chemotherapy within the past 2 years
- * Serious medical condition anticipated to prevent person from walking
- 1 mile (e.g., severe pulmonary disease or aortic stenosis)
- * Severe medical comorbidities that require aggressive treatment: e.g., stage 4 or greater renal disease, class III or greater heart failure, unstable coronary artery disease, liver or renal failure;
- * Diagnosis of a terminal illness and/or in hospice care;
- * Diagnosis of bipolar disorder or psychotic disorder within the last 2 years, or currently taking a mood stabilizer or antipsychotic medication
- * Initiation or change in type or dosing of antidepressant medications within 2 months prior to enrollment (The patient will be re-contacted for a later cohort once his/her regimen has been stable for at least 2 months unless the person declines to participate altogether.)
- * Have had or plan to undergo bariatric surgery during the study period
- Other exclusions:
- * Inability to speak, read or understand Spanish
- * Having no reliable telephone service
- * Having no regular Internet access via a computer and/or mobile device (e.g., smartphone)
- * Plan to move out of the area during the study period
- * Planned pregnancy
- * Family/household member of another study participant or of a study staff member
- * Investigator discretion for clinical safety or protocol adherence reasons
Ages Eligible for Study:
18 Years to N/A (ADULT, OLDER_ADULT)
Sexes Eligible for Study: FEMALE
Accepts Healthy Volunteers:
No