Episodic Future Thinking in a Fully Remote, Multi-Component Behavioral Intervention for Type 2 Diabetes: A Pilot/Feasibility Trial in Rural and Non-Rural Adults

Lifestyle changes including diet, exercise, and weight loss are critical for effective management of type 2 diabetes, but morbidity and mortality remain high because many patients do not adequately adhere to treatment goals. Treatment adherence provides its greatest health benefits (e.g., avoidance of diabetes-related complications such as renal disease) only after months or years of sustained lifestyle change; however, accumulating evidence demonstrates that individuals suffering from type 2 diabetes and related disorders (e.g., obesity) show elevated rates of delay discounting (i.e., devaluation of delayed consequences) and a bias for immediate gratification. The overall goal of this project is to facilitate weight loss and improve glycemic control in patients with type 2 diabetes using a remotely delivered episodic future thinking intervention (i.e., mental prospection) designed to reduce delay discounting, while minimizing participant and experimenter burden by using remote assessment of all study outcomes (e.g., weight, hemoglobin A1c).