Data analysis
depressive, OSF, sleep behaviors
We were interested in whether the EWS intervention improved key eat, walk, and sleep behaviors. In pre-planned analyses approved by the funder, we compared changes in key eat, walk, and sleep behaviors between the 2 groups that received EWS and the group that did not, across timepoints. Independent variables were experimental assignment (SS vs EWS vs EWS + MTM) and timepoint (baseline, 12-months, 15-months) and the dependent variables were as above. Descriptive statistics include means with standard deviations. Linear mixed models was used to test for change between groups. We first tested for differences between the two groups that received EWS intervention, i.e., EWS and EWS + MTM groups and, as expected, they showed a similar profile on the outcome variables. Thus, they were combined in the testing using contrasts statement and compared with the SS group. The linear contrasts tested for differences between the combined EWS/EWS + MTM group versus the SS group in the change from baseline to both the 12-month and 15-month time points. The physical activity and nutrition outcomes deviated severely from normality and typical transformations were unsuccessful in rectifying the issue. Therefore, values were converted to ranks and the mixed models were applied to the ranked data. For effect size Cohen’s d is reported for differences between experimental arms (EWS/EWS + MTM) and control arm (SS) at 12-months and 15-months.The nonparametric Spearman correlation was used to explore the relationship between change from baseline to 12-months in sleep, physical activity, and nutrition with change in primary outcomes of HbA1c, depressive symptoms, and logHOMA-IR. A significant correlation would suggest that the respective behavior may be mechanistically related to the primary outcomes, thus supporting targeting the behavior. In the EWS + MTM group, we calculated the proportion of participants for whom Metformin was recommended, who actually initiated Metformin treatment at any point across the 15 months. All available observations were used in the analyses and missing imputation was not performed as study retention was excellent (96% at 15-month follow-up). Statistical significance was set at an alpha level of 0.05. Analyses were conducted in SPSS v28 and syntax code is stored on the OSF link 