Mobile Health App to Reduce Diabetes in Latina Women with Prior Gestational Diabe

移动健康应用程序可减少患有妊娠期糖尿病的拉丁女性的糖尿病

• 批准号: 8665605
• 负责人: Dharma E CORTES
• 金额: $ 19.92万
• 依托单位: ENVIRONMENT AND HEALTH GROUP, INC.
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-22 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8665605
• 关键词: Address; Adopted; Adoption; Age; Algorithms; Behavior Therapy; Behavioral; Body Weight decreased; Car Phone; Centers for Disease Control and Prevention (U.S.); Communities; Computers; Data; Development; Diabetes Mellitus; Diabetes prevention; Eating; Economics; Education; Effectiveness; English Language; Epidemic; Ethnic Origin; Face; Funding; Future; Gender; Gestational Diabetes; Glosso-Sterandryl; Goals; Health; Hispanic Americans; Hispanics; Internet; Intervention; Knowledge; Language; Latina; Life Style; Modification; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Online Systems; Operating System; Outcome; Participant; Perception; Persons; Phase; Population; Populations at Risk; Pregnancy; Prevention; Race; Randomized; Randomized Clinical Trials; Recording of previous events; Relative Risks; Research; Research Infrastructure; Risk; Sample Size; Schedule; Self Efficacy; Small Business Innovation Research Grant; Solutions; System; Technology; Telephone; Testing; Text; Time; Translating; United States National Institutes of Health; Weight; Woman; base; behavior change; behavioral health; commercialization; community based care; comparison group; cost effective; diabetes prevention program; diet and exercise; evaluation/testing; evidence base; good diet; health care delivery; health disparity; high risk; improved; infrastructure development; innovation; innovative technologies; lifetime risk; mHealth; mobile application; prevent; primary outcome; public health relevance; randomized trial; reproductive; risk perception; secondary outcome; skills; theories; treatment as usual; usability

DESCRIPTION (provided by applicant): Hispanic women have the highest lifetime risk for type 2 diabetes (T2DM). A window of opportunity for preventing T2DM exists for women with pregnancies complicated by gestational diabetes mellitus (GDM). Women with prior GDM face increased risk of T2DM. Hispanic women are at increased risk of GDM, and those with GDM have higher relative risks for developing T2DM than non-Hispanic white women with GDM. The NIH-funded Diabetes Prevention Program (DPP) documented the effectiveness of lifestyle modification to prevent T2DM. Translating DPP research into community-based settings has been challenging. Recent development of mobile technologies offers promising solutions to taking knowledge obtained from experimental settings into community-based care. The proposed SBIR, building on the team's CDC-funded internet-based, GDM-modified DPP, would be the first to develop and test an interactive, culturally and individually-tailored, plain languae Spanish/English mobile health intervention (m-intervention) to reduce risk of T2DM for Hispanic women with recent GDM. The m-intervention leverages the widespread adoption of mobile phones in Hispanic women of reproductive age, and affords the opportunity to overcome physical barriers (accessible 24/7), knowledge barriers (education/skills development in plain Spanish/English), infrastructure barriers (not present using mobile phones), economic barriers (affordable), and cultural barriers (culturally acceptable). Using mobile phones to prevent T2DM in Hispanic women with prior GDM addresses the RFA's goal for..."existing technologies that have been redesigned based on the needs of a specific health disparity population." The proposed system is technologically innovative using participant-generated text messages for themselves as well as others. The Spanish/English mobile app features: culturally/individually tailored educational/motivational texts for behavioral change; algorithm-derived, individually tailored texts that are a) participant generated; b) automated, based on prior participant-defined schedule, and c) just in-time, based on real time participant input about current activities; and weight tracking. Our long-term goal is the prevention of T2DM in this at-risk population. Formative evaluations test the cultural acceptability of the texts and the usability of the app. A pilot randomized trial explores effectiveness of the app in changes in self-efficacy for healthy eating (primary outcome), weight loss (secondary outcome), and HBA1C, perceived risk for T2DM, and modified perceived risk (exploratory). Phase I results will provide data to determine sample size for the development/submission of a Phase II RCT of the m-intervention to promote healthy lifestyle to achieve weight loss among Hispanic women with recent GDM. The m-intervention offers potential of a scalable and cost-effective approach to decreasing health disparities and to improving health outcomes in Hispanic women with recent GDM, a high-risk, yet underserved group. The proposed application has broad commercialization potential given changes in health care delivery.

描述（由申请人提供）：西班牙裔女性一生中患2型糖尿病（T2 DM）的风险最高。妊娠合并妊娠糖尿病（GDM）的女性存在预防T2 DM的机会窗口。既往患有GDM的女性面临T2 DM风险增加。西班牙裔女性患GDM的风险增加，GDM患者患T2 DM的相对风险高于非西班牙裔白色GDM女性。NIH资助的糖尿病预防计划（DPP）记录了生活方式改变对预防T2 DM的有效性。将民进党的研究转化为以社区为基础的环境一直具有挑战性。移动的技术的最新发展为将从实验环境中获得的知识用于社区护理提供了有前途的解决方案。拟议的SBIR，建立在该小组的CDC资助的基于互联网的，GDM修改的DPP，将是第一个开发和测试一个互动的，文化和个性化定制的，简单的语言西班牙语/英语移动的健康干预（m-干预），以减少最近GDM的西班牙裔妇女的2型糖尿病的风险。移动干预措施利用了西班牙裔育龄妇女对移动的电话的广泛采用，并提供了克服物理障碍（全天候无障碍）、知识障碍（西班牙语/英语教育/技能发展）、基础设施障碍（使用移动的电话不存在）、经济障碍（负担得起）和文化障碍（文化上可接受）的机会。使用移动的手机来预防西班牙裔女性的T2 DM与先前的GDM地址RFA的目标...“根据特定健康差距人群的需求重新设计的现有技术。“拟议中的系统在技术上是创新的，使用参与者为自己和他人生成的短信。西班牙语/英语移动的应用程序的特点是：针对行为改变的文化/个人定制的教育/激励文本;算法衍生的、个人定制的文本，a）参与者生成的; B）自动的，基于先前参与者定义的时间表，以及c）及时的，基于参与者关于当前活动的真实的时间输入;以及体重跟踪。我们的长期目标是在这一高危人群中预防T2 DM。形成性评估测试文本的文化可接受性和应用程序的可用性。一项试点随机试验探讨了应用程序在健康饮食（主要结局）、体重减轻（次要结局）和HBA 1C自我效能变化方面的有效性，T2 DM的感知风险和修改的感知风险（探索性）。I期研究结果将提供数据，以确定开发/提交II期随机对照试验的样本量，该试验旨在促进健康的生活方式，以实现近期GDM西班牙裔女性的体重减轻。M-干预提供了一个可扩展的和具有成本效益的方法，以减少健康差距和改善健康结果的西班牙裔妇女与最近的GDM，一个高风险，但服务不足的群体。鉴于医疗保健服务的变化，拟议的应用具有广泛的商业化潜力。