An Intensive Longitudinal Investigation of Executive Functioning, Stress, and Physical Activity in Racially Diverse Adolescent Girls at Risk for Type 2 Diabetes<p

Adolescent-onset type 2 diabetes (T2D) is on the rise and a leading cause of medical complications, premature morbidity, and early mortality. Treatment is challenging, making prevention a high priority. Yet, standard lifestyle interventions aimed at preventing T2D show insufficient effectiveness. Current interventions likely fall short, at least in part, because they primarily focus on directly modifying health behaviors (e.g., physical activity), without addressing the role of broader, developmentally salient core principles that affect health behavior. It is critical to identify novel modifiable targets. Extant theory and empirical data suggest that executive functioning (EF) and stress may be such targets. The objectives in this application are (i) to test the acceptability/feasibility of novel ambulatory cognitive testing and self-reported ecological momentary assessment of EF, stress and physical activity in adolescent girls at risk for T2D, and (ii) to characterize how within-person momentary variability in EF and stress relate to physical activity, a paramount health behavior for T2D prevention. The knowledge gained from this study will lay the groundwork for future tailored just-in-time adaptive interventions that seek to promote physical activity by targeting underlying mechanisms.