Project Summary / Abstract: Obesity and related health disparities represent significant public health challenges that continue to have a negative impact on society. In particular, obese Latino youth are a key and vulnerable population that experience disproportionate rates of type 2 diabetes. To address these disparities, our team of academic and community partners through support from NIMHD and the Southwest Interdisciplinary Research Center has collaborated for 10 years to develop, implement, test, refine, and expand a community based-based, family- focused diabetes prevention intervention for obese Latino adolescents. Every Little Step Counts (ELSC) is a comprehensive lifestyle intervention that is framed within an Ecodevelopmental Model to leverage individual, social, community, and cultural factors in order to improve health behaviors (nutrition and physical activity) and reduce risk factors for type 2 diabetes among obese Latino adolescents. Preliminary results from our current P20-funded trial support the efficacy of the ELSC intervention to improve glucose tolerance among 90 obese Latino adolescents (age 14-16). We now propose a long-term follow-up of participants who completed ELSC over the past four years and are now young adults (age 18-22) in order to 1) describe individual diabetes- related health profiles following the lifestyle intervention and 2) examine how cultural family norms, the home food environment, and neighborhood environment are associated with changes in health profiles over time. We will use latent profile analyses to examine the following aims. Specific Aim 1: To describe individual diabetes risk profiles over a 5-year period in response to a culturally-grounded diabetes prevention intervention for obese Latino adolescents. Specific Aim 2: To examine whether cultural family norms that include family cohesion, familism, and supportive parenting styles are associated with individual diabetes risk profiles over time. Specific Aim 3: To examine whether the home food environment (availability of fruits, vegetables, high- sugar foods and beverages) is associated with individual diabetes risk profiles over time. Specific Aim 4: To examine if the neighborhood built environment (walkability) or social environment (disadvantage, cohesion, and trust) are associated with individual diabetes risk profiles over time. The project builds upon an established academic-community collaboration and a comprehensively characterized cohort from a vulnerable and underrepresented population. The team has an extensive track-record for translating research findings into meaningful health promotion and disease prevention interventions in the community. This project targets an understudied population that has undergone a critical developmental transition that is associated with future health outcomes. Lastly, the contextual factors of interest have not been studied in the context of long-term health changes following lifestyle intervention. The...