Mobile Health App to Reduce Diabetes in Latina Women with Prior Gestational Diabetes

Abstract Latino communities have been disproportionately impacted by the COVID-19 pandemic, being both atincreased risk and experiencing more severe illness when infected. Latinos living in Puerto Rico have alsobeen affected via access to healthy food. Even before the pandemic, access to healthy food had beenthreatened due to the unprecedented series of natural disasters, including Hurricane Maria in 2017. The onsetof COVID-19 has further threatened access to healthy food. Relatedly, social distancing rules, which limitaccess to beaches, parks and public recreation areas to prevent unhealthy crowding in these spaces, mayhave a greater negative impact on low-income Puerto Ricans who rely on these spaces for physical activity.While public health recommendations for healthy shopping, healthy eating, and physical exercise duringCOVID-19 have emerged, these recommendations have not targeted to Latinos nor are they available inSpanish. Puerto Ricans would benefit from targeted healthy shopping and eating guidance due to thewidespread food insecurity and poverty that already existed prior to COVID-19, and physical activity guidancedue to the COVID-19 related constraints to outdoor physical activity. Digital technology, which is widely used by Puerto Rico residents, is a way to help families engage inhealthy behaviors in the face of COVID-19, as it overcomes barriers by providing behavioral tools on healthyfood shopping and food preparation, and providing ways to increase physical activity. Tailoring thisinformation to Latinas, who typically manage shopping and food preparation in Latino families, wouldincrease its impact. To our knowledge, no digital health intervention has been specifically targeted to, andco-designed with Latinas to promote healthy food shopping, healthy eating, and physical activity duringCOVID-19. While such an intervention has potential value for many Latino subgroups, Puerto Ricansrepresent a high-priority target because of pre-existing vulnerabilities brought about by several naturaldisasters that preceded COVID-19. The overall goal of this competitive supplement is to develop a culturally- and individually-tailored Spanish/English digital health intervention to promote healthy food shopping and healthy eating, as well as physicalactivity, among Puerto Rican Latinas during the COVID-19 pandemic and its aftermath. This competitiverevision expands the scope of our current SBIR Phase II parent grant (Hola Bebé), which is building andtesting a digital health intervention with tools for healthy eating and physical activity for Latinas with a priorhistory of Gestational Diabetes Mellitus (GDM), as well as builds on our SBIR Phase I project (LISTA), whichdeveloped tools for healthy shopping and eating for Latinas. We are committed to the rapid dissemination ofthe mobile app during the pandemic and its aftermath, to Latina users of community health centers throughoutPuerto Rico, as well as other sites where Latinas access food.