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基于电话的有针对性的健康信息技术(Health IT)干预措施，用于旧金山湾区最近患有妊娠期糖尿病(PGDM)的少数民族妇女的糖尿病预防。这组女性构成了随后迅速发病的2型糖尿病(DM)的单一最可识别的风险群体，但对她们、她们的糖尿病知识或风险认知、行为、健康素养或与定制电话相关的偏好知之甚少 预防糖尿病的咨询干预。少数族裔女性，特别是拉丁裔和亚裔以及在美国以外出生的女性，比白人或非裔美国女性患GDM和DM的比例高得不成比例。糖尿病预防研究表明，通过饮食和锻炼，患糖尿病的长期风险可以显著降低(高达50%)。本项目的目标是使这些强化干预措施特别适用于最近生了孩子的低收入和少数民族PGDM妇女，她们在获得医疗保健和采取预防行为方面可能面临障碍。在拟议的研究中，我们将研究使现有有效的循证卫生信息技术工具适用于低收入少数民族PGDM妇女预防DM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结果方面是有效的。在这项魅力中心研究中，我们将采用参与式设计，与主要利益相关者共同开发针对糖尿病预防的ATSM干预措施，使其与低收入少数民族PGDM妇女相关，并将其更名为通过电话咨询和资源支持(STAR-MOMS)。然后，我们将用英语和西班牙语对STAR MOMS进行一项试点随机临床试验，试验从怀孕结束开始，持续9个月，在旧金山综合医院接受护理的主要是拉丁裔和亚洲PGDM妇女的样本中进行。旧金山综合医院是一家大型公立医院，SF县安全网诊所的GDM妇女在那里接受护理。研究结果包括：体重减轻(公斤)、运动和饮食改变、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.