(P42-15-26) A Protocol for Preliminary Examination of an Innovative mHealth-Based Dietary Fiber Intervention to Improve Outcomes in Young Adults With Prediabetes

Objectives: In the United States, 1 in 4 young adults (YAs) has prediabetes. Diet is a key contributor to diabetes risk, including fiber intake. Fiber intake has been poor for decades and resistant to change in response to standard interventions. The objective of this study is to establish and preliminarily test a highly innovative and scalable mobile phone (mHealth)-based intervention to improve dietary fiber intake and decrease diabetes risk among YAs with prediabetes.

Methods: We will recruit n=40 YAs with laboratory-confirmed prediabetes for this single-arm feasibility trial. Participants will undergo a 3-month intervention followed by a 4-week observation period. The intervention has been designed and includes three main components: mobile phone-delivered text- and video-based behavior change content; home-delivered foods containing intrinsic fiber as a means of introducing high fiber foods; and biofeedback using Dexcom G7 continuous glucose monitors. Foods for home delivery were selected based on whether they are a “good source” of fiber (≥3g of fiber/serving). At least three recipes for each food is included on the mHealth app for participant use. At baseline, post-intervention, and post-observation, diet will be assessed (Diet History Questionnaire III). At baseline and post-intervention, insulin resistance (Homeostatic Model Assessment for Insulin Resistance [HOMA-IR]) will be assessed. During the 4-week observation period, participants will complete daily ecological momentary assessment to examine factors associated with maintenance of dietary intake at post-observation. Feasibility will be evaluated based on recruitment, retention, and completion of data collection procedures.

Results: This protocol was approved by the Institutional Review Board in August 2025, and mHealth intervention content is currently in development and undergoing internal pilot testing. Recruitment is anticipated to begin March 2026.

Conclusions: Results of this feasibility study will provide critical insights into this novel intervention modality and inform future refinements as well as full efficacy testing.

Funding Sources: Harold Hamm Diabetes Center Novel Pilot Grant, Hudson Fellowship program, the National Cancer Institute, and the Oklahoma Tobacco Settlement Endowment Trust (TSET).