Mobile Health Dietary Intervention for Stroke Survivors With Prediabetes or Type 2 Diabetes

NCT07120334 | Recruiting DMC

• 1 other identifier: RA-2025-302
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Objectives: This study aims to test whether a mobile app called PortionSize Ed can help adults who have had a recent stroke and also have prediabetes or type 2 diabetes improve their diet. Specifically, we want to see if the app can help people follow a Mediterranean-style diet, which may lower the risk of future strokes and improve overall health. The main goals are to:

• Test if the app is easy to use and acceptable to participants.
• See whether the app helps people follow a healthier diet.
• Look at changes in health indicators like blood sugar, cholesterol, blood pressure, and body fat. Design and Outcome: This is a randomized controlled pilot study that will involve 40 participants. All participants will be recruited from Queen's Medical Center after a recent stroke and will be randomly assigned to one of two groups: Intervention Group: Uses the full PortionSize Ed app, gets weekly reminders and educational videos, and has 3 sessions with a registered dietitian (RDN) over 12 weeks. Control Group: Uses a basic version of the app without feedback or RDN support, and receives usual care for stroke recovery. All participants will continue to receive standard care from Queen's, including the My Stroke Recovery Guide. The study lasts 12 weeks, with visits at the beginning and end to collect health data and feedback on the app. Schedule and Type of Evaluations/Interventions: Participants will complete the following: Baseline and Week 12 Visits: In-person assessments for blood sugar (HbA1c), cholesterol, blood pressure, height, weight, and body composition (using DXA, BIA, and 3D imaging), as well as surveys about their diet and activity levels. Intervention Group Only:
• Three virtual counseling sessions with a registered dietitian (Week 1, 6, 12)
• Weekly nutrition goal tracking and texting with the dietitian
• Watching short educational videos through the app
• Receiving app-based feedback on how well their diet follows Mediterranean Diet recommendations Duration of Study: The study will last 12 weeks for each participant, with an optional long-term follow-up using medical records. Sample Size and Population: The study will include 40 adults, ages 30 to 65, who:
• Recently experienced a stroke
• Have a history of prediabetes or type 2 diabetes
• Are medically stable and able to use a smartphone (or willing to use a study-provided iPhone)
• People will be excluded if they have severe swallowing issues, cognitive problems, or dietary needs that would make it hard to follow a Mediterranean-style diet.

Conditions

Stroke Recurrence; Type 2 Diabetes; Prediabetes

Keywords

PortionSize Ed; Stroke; Diabetes; Prediabetes; Type 2 Diabetes; T2D; Mediterranean Diet; mHealth; Hawaii

Outcome Measures

Primary Outcomes (4)

• Participant Acceptability of PortionSize Ed App

  Mean acceptability score measured by the Computer System Usability Questionnaire (CSUQ), a validated 19-item Likert scale instrument assessing system usefulness, information quality, and interface quality. Each item is scored on a 7-point scale ranging from 1 (Strongly Agree) to 7 (Strongly Disagree). Unit of Measure: Mean CSUQ score (1-7) Direction of Scoring: Lower scores indicate higher acceptability and better usability.

  11 months

• Participant Retention Rate

  Percentage of participants who complete all scheduled study assessments (Weeks 1, 6, 12). Higher percentages indicate better retention and feasibility of the intervention.

  11 months

• Participant Satisfaction with Study Procedures and App Features

  Description: Mean satisfaction score measured using the PortionSize Ed User Satisfaction Survey (USS), a 10-item Likert-style instrument that evaluates ease of use and satisfaction with app components including photo features, videos, and feedback. Items are scored on a scale of 1 to 5. The USS also includes open-ended questions for qualitative feedback. Units of Measure: Score on a 1-5 Likert scale (higher scores indicate greater satisfaction) Direction of Scoring: Higher scores indicate greater satisfaction and ease of use.

  11 months

• Participant Engagement with the PortionSize Ed App

  Mean number of app logins and food photo entries submitted by participants over the 12-week intervention period. Engagement will be assessed using backend app usage data, with higher counts indicating greater engagement.

  11 months

Secondary Outcomes (8)

• Mediterranean Diet Adherence Score (MEDAS-14)

  11 months

• App-Based Proportion-of-Goal Mediterranean Diet Adherence Score

  11 months

• Change in Hemoglobin A1c (HbA1c) from Baseline to Week 12

  11 months

• Change in Lipid Profile from Baseline to Week 12

  11 months

• Change in Systolic and Diastolic Blood Pressure from Baseline to Week 12

  11 months

Study Arms (2)

PortionSize Ed + MedDiet Support

EXPERIMENTAL

Full PortionSize Ed app access with personalized dietary feedback, educational videos, 3 virtual sessions with a registered dietitian (RDN), standard of care (for post-stroke with pre-diabetes or T2D) over 12 weeks.

Behavioral: PortionSize Ed + MedDiet Support

Standard of Care

ACTIVE COMPARATOR

Uses a basic version of the app without feedback or RDN support and receives usual care for stroke recovery for 12 weeks.

Behavioral: Standard of care for Stroke and Prediabetes or T2D

Interventions

Standard of care for Stroke and Prediabetes or T2D BEHAVIORAL

Uses a basic version of the PortionSize Ed app without feedback or RDN support and receives usual care for stroke recovery and prediabetes or T2D for 12 weeks.

Standard of Care

PortionSize Ed + MedDiet Support BEHAVIORAL

Full PortionSize Ed app access with personalized dietary feedback, educational videos, 3 virtual sessions with a registered dietitian (RDN), standard of care (for post-stroke with pre-diabetes or T2D) over 12 weeks.

PortionSize Ed + MedDiet Support

Eligibility Criteria

• Age: 30 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Aged 30 to 65 years
• Recent stroke (ischemic, hemorrhagic or Transient Ischemic Attack), within 1-14 days prior to enrollment
• Confirmed diagnosis of prediabetes or type 2 diabetes, based on HbA1c results
• Medically stable and cleared for oral diet and physical activity by the attending physician
• Cleared for thin liquids and regular textures by physician
• Capable of providing informed consent
• Able to speak and read English
• Owns a smartphone OR is willing to use a study-provided iPhone
• Has sufficient cognitive and physical function to use a mobile app
• Willing to participate in all study procedures and available for the 12-week duration

You may not qualify if:

• Severe dysphagia that prevents oral intake
• Type 1 diabetes
• Cognitive impairment (e.g., dementia, post-stroke confusion) that precludes consent or compliance, as judged by the clinical care team
• Current participation in another interventional clinical trial
• Pregnant or breastfeeding, or planning to become pregnant during the study period
• Unwilling or unable to provide written informed consent
• Serious comorbid conditions that, in the opinion of the

Sponsors & Collaborators

• University of Hawaii: lead
• Queen's Medical Center: collaborator

Study Sites (1)

University of Hawaii Cancer Center

Honolulu, Hawaii, 96813, United States

RECRUITING

MeSH Terms

Conditions

Diabetes Mellitus, Type 2; Prediabetic State; Stroke; Diabetes Mellitus

Interventions

Standard of Care

Condition Hierarchy (Ancestors)

Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Intervention Hierarchy (Ancestors)

Quality Indicators, Health Care; Quality of Health Care; Health Services Administration; Health Care Quality, Access, and Evaluation

Central Study Contacts

Chloe P Lozano, PhD, MS, GradDip Dietetics

CONTACT

(808) 586-3010; cpanizza@hawaii.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 28, 2025
• First Posted: August 13, 2025
• Study Start: February 1, 2026
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: January 21, 2026

Record last verified: 2026-01

Locations

US (1)