Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 14, 2025
Open Peer Review Period: Aug 15, 2025 - Oct 10, 2025
Date Accepted: Feb 24, 2026
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Social Partner Effects on Type 2 Diabetes Prevention and Management and “Spillover” Health Effects: Better Together Pilot
ABSTRACT
Background:
South Asian (SA) Americans are at high risk of prediabetes (pre-DM) and diabetes (T2DM). SA populations are typically close-knit communities, with support networks that could be leveraged in lifestyle interventions.
Objective:
This was a single-arm, pre-post pilot study to evaluate the feasibility and efficacy of a culturally tailored telehealth intervention for SA adults with pre-DM or T2DM and their social partners (trusted household members; SPs) who co-participated in the intervention.
Methods:
Participants attended five hour-long health education sessions delivered in English and Bengali. Participant outcomes included pre-post changes in hemoglobin A1c (HbA1c), body mass index (BMI), blood pressure (BP), self-reported minutes of physical activity, and dietary choices at baseline and at the 6-month follow up. For SPs, outcomes included pre-post survey changes in physical activity and dietary choices. We used Pearson chi-square tests and paired t-tests to compare baseline measures with post-intervention outcomes.
Results:
This study included 54 participants and 106 SPs in Atlanta, GA between March 2021 and November 2023. All participants were Bangladeshi and spoke native Bengali. SPs were most commonly participants’ children (36.8%) or spouses (32.1%). Participant baseline HbA1c was 7.5% (SD=1.48), which decreased by -0.84% (95% CI: 0.83, p=.0002*). Participants also improved systolic BP by -5.8 mmHg (95% CI: 11.2, p=.0428*) with no change in diastolic BP (-0.45 mmHg, 95% CI: 3.9, p=0.642) or BMI ( –0.64 kg/m2, 95% CI: 2.5, p=0.298). Compared to baseline, 39% more participants exercised at least 150 minutes weekly (p<.0001), but there was no difference in self-reported fruit and vegetable intake. However, in the SP survey, SPs increased fruit and vegetable intake (95% CI: 0.78, p=.019*), decreased soda intake (p<.0001*), and increased daily moderate exercise (p=.0031*).
Conclusions:
Including SPs in T2DM prevention and management is feasible and potentially beneficial, but comparative studies are needed to determine the incremental effects of SP participation vs. individual-focused lifestyle interventions. Clinical Trial: ClinicalTrials.gov (NCT05275231
Citation
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