Adapting an Automated Telephone Support Program to Prevent Type 2 Diabetes

项目总结（见说明）： 我们建议开发和测试一种有针对性的基于电话的健康信息技术（健康IT）的干预措施，用于在旧金山弗朗西斯科湾地区的少数民族妇女中预防糖尿病，这些妇女最近患有妊娠糖尿病（pGDM）。这组妇女构成了随后快速发病的2型糖尿病（DM）的单一最可识别的风险组，但对她们、她们的糖尿病知识或风险认知、行为、健康素养或她们与定制的基于电话的治疗相关的偏好知之甚少。 预防DM的干预措施。少数民族妇女，特别是拉丁裔和亚洲人以及在美国境外出生的妇女，GDM和DM的发病率不成比例地高于白色或非洲裔美国妇女。糖尿病预防研究表明，通过饮食和运动可以显着降低患糖尿病的长期风险（高达50%）。该项目的目标是，专门针对低收入和少数民族pGDM妇女调整这些强化干预措施，这些妇女最近刚生完孩子，可能在获得医疗保健和采取预防行为方面面临障碍。在拟议的研究中，我们将研究现有的有效的循证健康IT工具，以预防糖尿病在低收入的少数民族pGDM妇女的适应的关键因素。我们在比较有效性研究中确定，我们的自动电话自我管理支持（ATSM）计划在改善低收入少数民族糖尿病患者的健康状况方面是有效的。在这项CHARM中心研究中，我们将采用参与式设计，与关键利益相关者共同开发ATSM干预措施，以预防DM，使其与低收入少数民族pGDM妇女相关，并将其重新命名为通过电话咨询和资源支持（STAR-Moms）。然后，我们将在旧金山弗朗西斯科综合医院（一家大型公立医院，旧金山县安全网诊所的GDM女性接受护理）接受护理的主要为拉丁裔和亚裔pGDM女性的样本中，以英语和西班牙语对星星妈妈进行一项试验性随机临床试验，从妊娠结束开始，持续产后9个月。研究结果包括：体重减轻（kg），运动和饮食变化，知识和预防服务的使用。

PROJECT SUMMARY (See instructions): We propose to develop and test a targeted telephone-based health information technology (health IT) intervention for diabetes prevention among ethnic minority women in the San Francisco Bay area with recent prior gestational diabetes (pGDM). This group of women comprises the single most identifiable risk group for subsequent rapid onset of type-2 diabetes (DM), yet little is know about them, their diabetes knowledge or risk perceptions, behaviors, health literacy, or about their preferences related to tailored telephone-based counseling interventions to prevent DM. Ethnic minority women, particularly Latinas and Asians and women born outside the US, have disproportionately higher rates of GDM and DM, than white or African American women. Diabetes prevention studies indicate that the long-term risk for developing DM can be reduced significantly (up to 50%) through diet and exercise. Adapting these intensive interventions specifically to low income and ethnic minority pGDM women who have recently had a baby and may face barriers in accessing health care and adopting preventive behaviors is the goal of this project. In the proposed research we will study factors crucial to the adaptation of an existing effective evidence-based health IT tool to the prevention of DM in low-income ethnic minority pGDM women. We have determined in comparative effectiveness studies, that our Automated Telephone Self-Management Support (ATSM) program is efficacious in improving health outcomes for low-income ethnic minority patients with diabetes. In this CHARM Center study, we will use a participatory design to co-develop the ATSM intervention for DM prevention with key stakeholders, so that it is relevant to low income ethnic minority pGDM women and re-name it Support via Telephone Advice and Resources (STAR-Moms). We will then conduct a pilot randomized clinical trial in English and Spanish of STAR Moms beginning in the end of pregnancy and lasting 9 months post-partum among a sample of primarily Latina and Asian pGDM women receiving care at San Francisco General Hospital, a large public hospital where GDM women in the SF county safety net clinics receive care. Study outcomes include: weight loss (kg), exercise and diet changes, knowledge, and use of preventive services.