Women's Lifestyle Balance Study

The goal of this pilot study is to determine whether the efficacy of an existing lifestyle
improvement program can be increased by adding a sleep extension and sleep hygiene
intervention. Improved sleep can improve weight loss through two possible routes: lessening
fatigue may potentiate physical activity (PA), and decreasing appetite may potentiate diet
improvements. A sample of 24-30 women will be assigned to either the Centers for Disease
Control's (CDC's) standard PreventT2 program or the same program with an additional
integrated sleep intervention. Both programs will involve 8 group sessions administered over
3 months, and all women will be followed for a total of 6 months. The primary outcome is
weight loss, and secondary outcomes include sleep quality and duration, physical activity,
caloric intake, and physiological indicators of cardiovascular and diabetes risk (HbA1c,
HOMA-IR, lipids, blood pressure). The combined program has the potential to significantly
improve weight loss in those at risk for diabetes and cardiovascular disease (CVD).

Inclusion Criteria:

- Female (or self-identify as female)

- Age 30-70 years

- BMI 25-38 (or 23-38 if Asian or other Pacific Islander)

- Time in bed <= 7 hours on a typical weeknight

- Meets diagnostic criteria for prediabetes and/or metabolic syndrome

Exclusion Criteria:

- No regular access to telephone or email (for maintaining contact);

- No access to smartphone, tablet, or laptop computer (for using Fitbit);

- Having a condition that limits physical activity, such as brisk walking;

- Having a diagnosis of type 1 or type 2 diabetes or been previously treated with
diabetes medications;

- Having a cardiac event or cardiac surgery in the past year;

- Having a metabolic condition that prevents weight loss;

- Working night shift (Midnight - 4 AM)

- Inability to complete the baseline assessment (REDCap survey and Fitbit tracking of
activity, diet, and sleep for 7 days)