Family Focused Community Program to Prevent Type 2 Diabetes in Peripubertal Youth

Percentage overweight will be calculated as percentage over the median body mass index (BMI) for age and gender and change in BMI zscore

Diet quality was assessed using the Healthy Eating Index-2010 (HEI-2010), which measures adherence to the 2010 Dietary Guidelines for Americans. Scores range from 0 to 100, with higher scores indicating greater adherence and better diet quality.

HEI-2010 scores were computed from 24-hour recall data collected at baseline and Week 12 (post-intervention).

Physical activity was objectively measured using GT3X accelerometers worn on the hip for 7 consecutive days at baseline and again at Week 12 (post-intervention). Data were processed using ActiLife software with standard youth cut points to classify activity intensity levels.

Waist circumference (cm) was measured at the level of the umbilicus using a non-stretchable measuring tape, following standard anthropometric procedures. Measurements were taken at baseline and at Week 12 (post-intervention) with participants standing and breathing normally.

The reported value represents the mean change in waist circumference from baseline to Week 12 across all participants. The change score was calculated as the Week 12 measurement minus the baseline measurement; positive values indicate an increase and negative values indicate a decrease in waist circumference over the 12-week intervention period.

Total cholesterol (mg/dL) was measured from fasting venous blood samples collected at baseline and Week 12 (post-intervention). The reported value represents the mean change in fasting total cholesterol from baseline to Week 12 across all participants. The change score was calculated as the Week 12 value minus the baseline value for each participant; positive values indicate an increase and negative values indicate a decrease in total cholesterol during the 12-week intervention period.

Because this was a feasibility study not powered to detect between-group differences, results for both delivery formats (face-to-face and hybrid) were analyzed in aggregate. Arm-level estimates were not calculated or retained, as separate estimates were not meaningful for this exploratory outcome.

Fasting plasma glucose (mg/dL) was measured from venous blood samples collected after an overnight fast at baseline and at Week 12 (post-intervention). The reported value represents the mean change in fasting glucose from baseline to Week 12 for all participants combined. The change score was calculated as the Week 12 value minus the baseline value for each participant; positive values indicate an increase and negative values indicate a decrease in fasting glucose during the 12-week intervention period.

Because this was a feasibility study not powered for between-group comparisons, data from both intervention formats (face-to-face and hybrid) were analyzed in aggregate. Arm-level results were not calculated or retained, as separate estimates were not meaningful for this exploratory outcome.

Fasting insulin (µU/mL) was measured from venous blood samples collected after an overnight fast at baseline and at Week 12 (post-intervention). The reported value represents the mean change in fasting insulin from baseline to Week 12 for all participants combined. The change score was calculated as the Week 12 value minus the baseline value for each participant; positive values indicate an increase in fasting insulin over the 12-week intervention period, and negative values indicate a decrease. Because this was a feasibility study not powered for between-group comparisons, results were analyzed in aggregate across both intervention arms.

Blood pressure was measured in duplicate after 5 minutes of seated rest using an automated oscillometric device. The mean of the two readings was used. Because the study was designed to assess feasibility and not efficacy, blood pressure change was analyzed descriptively across the combined cohort.