Feasibility, Acceptability, and Efficacy of Using a Mobile Health Application for Lifestyle Modification in Youth With Prediabetes: A Prosper App Study

OBJECTIVE Mobile health (mHealth) applications (apps) help individuals achieve healthy lifestyle behaviors. We assessed feasibility, acceptability, and efficacy of an mHealth app, Prosper, in helping adolescents with prediabetes track and achieve lifestyle modifications. RESEARCH DESIGN AND METHODS This prospective pilot study enrolled adolescents aged 13–17 years with prediabetes. Participants downloaded the Prosper app and use was followed for 3 months after a prediabetes visit. App use, check-ins, and habits data were analyzed; surveys assessed feasibility, acceptability, and participant-reported efficacy. Primary outcomes were use and feasibility or acceptability of the app. Secondary outcomes included changes in BMI and hemoglobin A1c (HbA1c). Caregivers and providers were also surveyed. RESULTS The study enrolled 25 participants (median age 15.1 years; 76% female; 64% identified as Black adolescents; 76% identifed as non-Hispanic; and 56% had Medicaid insurance). Participants completed 2,057 habits, 575 check-ins, and 114 journals overall. The median number of check-ins per participant was 4 (interquartile range 2–18), and 36% completed ≥12 check-ins. Most participants (68%) set at least 2 habits, with a maximum of 14 habits. High satisfaction was reported by 74–87%. Most found the app easy to use (95.7–100%), helpful for tracking nutrition (61–78%) and exercise (56.5–86%), and easy to integrate into daily routines (52–73%). Baseline median BMI was 37.7 kg/m2 (interquartile range 32.0–43.3) and HbA1c was 5.7% (interquartile range 5.6–5.8), without change noted after 3 months. CONCLUSIONS Adolescents reported high satisfaction with the Prosper app and found it easy to use, helpful for tracking nutrition and exercise goals, and easy to incorporate into daily routines. mHealth tools may support adolescent lifestyle modifications between clinical visits with broad scalability.