Despite growing numbers of initiatives designed to address increasing type 2 diabetes prevalence in rural communities, the need remains for effective programs. Because family history is a T2DM risk factor, family-focused programs may be a potential strategy to improve the health of all family members. We present the results of a one-group pre-post pilot test of a family-focused program for rural-dwelling caregivers at risk for T2DM and their children.

Rural-dwelling caregiver and child dyads with T2DM family history were enrolled. The 3-month program was delivered over Zoom and focused on health, wellness, and intrinsic incentives of engaging in health-enhancing activities as a family. Data were collected pre- and post-intervention with physical activity (PA) measured using ActiGraph wGT3X-BT (caregivers) and Garmin Vivofit Jr 3 trackers (children). Caregivers completed questionnaires assessing global health, PA, family cohesion, social support, and family health. Post-intervention semi-structured interviews assessed program feasibility and satisfaction.

17 dyads (N=34) were enrolled. Caregivers were female, on average 42.2 (SD=7.9) years and 94% had attended some college or more with an annual income of ≥$40,000. Children were on average 8.7 (SD=1.3) years. Fifteen dyads completed the study with 86% program session attendance. Caregivers’ Actigraph measured moderate to vigorous PA increased post-intervention by 40.0 (p=.01) and self-reported PA by 545.4 MET-min/week (p=.04). Children’s mean daily step counts increased post-intervention by 9.8 minutes (p=.08) and 1226.3 steps (p=.08). Caregiver reported measures at showed improvements post-intervention to child global health (p=.052) and to adult global health (p=0.12), social support (p=.004), and family cohesion (p=.08). Interviews showed that the program was feasible to implement and acceptable with participants providing suggestions to improve program content and protocols for future offerings.

This remotely delivered, family-focused lifestyle change program was found to be feasible with promising results indicated for PA, global health, social support, and family cohesion. Because family-focused programs acknowledge that health behaviors are shaped and influenced by familial and environmental contexts, programs that include both children and caregivers have the potential to impact not only adult outcomes but also improve the health habits of youth at higher risk for developing T2DM.