Understanding Patient Engagement in Lifestyle Programs for Diabetes Prevention among Women with a Recent History of GDM

摘要 2 型糖尿病影响着美国超过 1300 万女性。改善体重管理的生活方式计划， 饮食和体力活动可以预防 2 型糖尿病，建议高危成人使用，并且 越来越多地应用于医疗保健服务系统。然而，尽管先前的研究主要集中在功效和 生活方式计划的有效性，很少有研究考察与患者参与相关的因素 现实临床环境中的生活方式计划。项目参与度低和人员流失率高可能会导致 患者的健康结果较差。关于患者参与的研究对于患有以下疾病的女性尤其重要 有妊娠糖尿病史的人患 2 型糖尿病的风险明显更高。推进该领域 预防糖尿病和改善高危人群的医疗保健服务是该项目的总体目标 提议是确定与参与有效的生活方式计划相关的患者特征 代表综合医疗保健服务系统向最近有过以下经历的不同女性提供服务： 妊娠期糖尿病。该项目旨在确定患者特征，从而识别有风险的亚组 患者参与度差（目标 1），并为这些亚组制定有意义的描述性概况（目标 2）。 这种二次分析利用了电子健康记录和患者报告的独特来源 信息。结果可能会创造性地为未来有针对性的外展和课程材料的设计提供信息，以 最大限度地提高计划参与度，最终目标是改善年轻和多样化人群的健康 2 型糖尿病的高风险。

ABSTRACT Type 2 diabetes affects over 13 million women in the US. Lifestyle programs to improve weight management, diet, and physical activity can prevent type 2 diabetes, are recommended for high-risk adults, and are increasingly available in healthcare delivery systems. Yet while prior research has focused on the efficacy and effectiveness of lifestyle programs, little research has examined factors associated with patient engagement in lifestyle programs in real-world clinical settings. Low program participation and high attrition may contribute to poorer health outcomes for patients. Research on patient engagement is especially important for women with a history of gestational diabetes, who face markedly higher risk for type 2 diabetes. To advance the field of diabetes prevention and improve healthcare delivery for individuals at high risk, the overall objective of this proposal is to identify patient characteristics associated with engagement in an effective lifestyle program offered on behalf of an integrated healthcare delivery system to diverse women with a recent history of gestational diabetes. The project aims to determine patient characteristics that identify subgroups at risk for poor patient engagement (Aim 1), and to develop meaningful descriptive profiles of these subgroups (Aim 2). This secondary analysis leverages a unique source of electronic health record and patient-reported information. Results may creatively inform the future design of targeted outreach and curriculum materials to maximize program participation, with the ultimate goal of improving health in a young and diverse population at high risk for type 2 diabetes.