ActiveGirls: Physical Activity, Hormone Health, and Diabetes Risk in Early Adolescence

Inclusion Criteria: * Caregiver: Caregiver of child (ie mother, father, or other legal guardian), English-speaking, Access to a device where they are able to receive study e-mails or texts * Child: English-speaking, Female, ages 8-12 years old at time of enrollment, Pre-menarchal at time of baseline visit, at risk for Polycystic Ovary Syndrome (PCOS)/insulin resistance, as defined by (1) History of maternal PCOS/maternal GDM, (2) BMI \>/= 85th percentile, (3) History of premature adrenarche, or (4) Small (\<10th %ile) for gestational age Exclusion Criteria (Child): * Medications at time of enrollment: Metformin, GLP-1R Agonist, Insulin, GnRH agonist * Endocrine conditions that would impact either insulin sensitivity, androgen concentrations, or growth * Insulin dynamics: Type 1 diabetes, Type 2 diabetes, Congenital Hyperinsulinism * Androgen Conditions: Adrenal tumor, Congenital Adrenal Hyperplasia * Hyperthyroidism or uncontrolled hypothyroidism (TSH \>7.0 mIU/mL) * Growth Hormone Deficiency * Medical conditions that would impact PA participation: Type 1 diabetes; Cardiovascular, neurologic, and/or musculoskeletal conditions limiting ability to participate in physical activity. * Other medical comorbidities that would limit generalizability of findings, including: Severe congenital heart disease, Congenital anomalies, Cystic fibrosis, Cerebral palsy, Condition requiring use of nasogastric, gastric tube, or other alternative method of feeding, Undiagnosed conditions with s…