This NIDDK funded study aims to reduce BMI in overweight adolescents by intervening on physical activity and nutrition behaviors with 124 adolescents aged 12 -16 who meet the American Diabetes Association criteria for high risk of Type 2 diabetes.

Subjects are randomly assigned to one of the following four conditions and followed over a 12 month period:

1)usual medical care through pediatric and primary care provider offices

2)a web-based nutrition and physical activity intervention and ongoing case management by phone and e-mail

3)web-based intervention, case management, counseling calls, and face-to-face group sessions

4)cell phone and web-based intervention

The program emphasizes the importance of familial influence by including parent participation in all arms of the study.  The web-based intervention for parents includes specific parenting information on how to set up a home environment to promote weight loss and healthy eating and activity.

Participants randomized to one of the three intervention groups receive the following on a weekly basis:

•physical activity and nutrition information

•weight loss goals (including self monitoring techniques)

•behavioral skills

•tailored feedback from a case manager and interactive feedback via a website on goals, progress, and strategies for improvement

Adolescent and parent/guardian participants are measured at baseline, 6 months, and 12 months.  The primary outcome will be the effect of the PACEi-DP intervention on BMI at 12 months on overweight adolescents at risk for Type 2 Diabetes.  Secondary outcomes will be: 

1)  metabolic and physiological measures of insulin resistance;

2) anthropometric measures (DEXA and waist to hip ratios); and           

3) behavioral measures (moderate and vigorous physical activity, total energy expenditure, CSA, measures of sedentary behavior, servings of fruit, vegetables, fiber and total fat),

4) psychosocial mediators of change. 

Exploratory outcomes include:

1) psychosocial mediators of change;

2) measures of parent/guardians’ BMI and waist/hip ratios; and

3) process, satisfaction, and cost-effectiveness measures of each comparison group.