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1300多万女性。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，推荐给高危成人， 越来越多地应用于医疗保健系统。然而，虽然先前的研究集中在疗效和 生活方式计划的有效性，很少有研究检查与患者参与 生活方式项目在现实世界的临床环境中。低计划参与率和高流失率可能会导致 患者的健康状况较差。对患者参与度的研究对于患有 有妊娠糖尿病史者，患2型糖尿病的风险明显更高。为了推进 糖尿病预防和改善高危人群的医疗保健服务， 建议是确定与参与有效生活方式计划相关的患者特征 代表一个综合医疗保健提供系统提供给不同的妇女与最近的历史， 妊娠糖尿病该项目旨在确定患者的特征，以确定亚组的风险， 患者参与度差（目标1），并对这些亚组进行有意义的描述性分析（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.研究结果可为今后有针对性的外联和课程材料的设计提供创造性的信息， 最大限度地提高项目参与度，最终目标是改善年轻和多样化人口的健康状况， 患2型糖尿病的风险很高。

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.