Group versus Traditional Prenatal Care for Diabetes: A Randomized Controlled Trial

糖尿病的团体产前护理与传统产前护理：随机对照试验

• 批准号: 10224882
• 负责人: Ebony Boyce Carter
• 金额: $ 15.06万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10224882
• 关键词: Achievement; Admission activity; Adoption; African American; Apgar Score; Area; Award; Behavior; Biometry; Body Composition; Body Weight decreased; Breast Feeding; Cardiovascular Diseases; Cardiovascular system; Caring; Child; Chronic Disease; Clinical; Clinical Trials; Complement; Contraceptive methods; Data; Databases; Development; Diabetes Mellitus; Disease; Dystocia; Education; Enrollment; Event; Exercise; Foundations; Funding; Future; Gestational Age; Gestational Diabetes; Glucose; Glycosylated hemoglobin A; Goals; Habits; Health; Health Promotion; Hematocrit procedure; Hypoglycemia; Icterus; Impairment; Intervention; K-Series Research Career Programs; Knowledge; Life; Low income; Measures; Medical; Mental Depression; Mentors; Mentorship; Meta-Analysis; Modeling; Mothers; Neonatal Mortality; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Obesity Epidemic; Observational Study; Outcome; Outcome Study; Patients; Pattern; Pharmacotherapy; Phase; Positioning Attribute; Postpartum Period; Postpartum Women; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy in Diabetics; Pregnant Women; Premature Birth; Prenatal care; Psychosocial Stress; Public Health; Publishing; Randomized; Randomized Controlled Trials; Research; Research Activity; Respiratory distress; Risk; Risk Reduction; Shoulder; Testing; Time; Training; Training Activity; Training Support; United States; Visit; Weight; Woman; Work; antenatal; cardiovascular health; community based participatory research; comorbidity; cost effective intervention; diabetic patient; dietary control; experience; follow-up; glycemic control; improved; improved outcome; innovation; lifetime risk; maternal outcome; maternal weight; neonatal outcome; obesity development; obesity risk; patient oriented; patient oriented research; postpartum health; postpartum weight; pregnancy disorder; pregnant; prenatal; programs; psychosocial; randomized controlled design; randomized trial; reproductive; social stress; stillbirth; success; systematic review; traditional care

Project Summary/Abstract As rates of Type 2 Diabetes, Gestational diabetes mellitus, and hypertensive disorders of pregnancy rise, so do the challenges of antepartum treatment and postpartum risk-reduction for future adverse cardiovascular events. The purpose of this Mentored Patient-Oriented Career Development Award (K23) is to enable the candidate to develop a funded research program that optimizes management of medical co-morbidities during pregnancy and identifies innovative ways to alter a woman's future chronic disease trajectory. To achieve this goal, training and mentorship are proposed in three key areas: 1) Advanced training in community-based participatory research, biostatistics, and clinical trials, 2) Protected time to perform patient-oriented research on the ability of a group diabetes-focused prenatal care program to improve postpartum health, and 3) Foundational research and introductions to relevant databases to facilitate future research on the relationship between pregnancy complications and future cardiovascular disease to facilitate research in the next phase. The research plan for this award will be implemented with the support of the training plan and an interdisciplinary team of expert mentors and advisors. The proposed project examines the ability of group prenatal diabetes care, Diabetes Centering Pregnancy (Diabetes CP), to improve outcomes for low-income pregnant African-American women with diabetes. These women are at increased long-term risk of developing cardiovascular disease, and this project takes advantage of the antenatal period to promote healthy behaviors that may carry over into the postpartum period and thus reduce this risk. Specifically, this project will determine whether Diabetes CP reduces maternal postpartum weight retention up to one year. The project will employ a randomized controlled design and a rigorous, systematic approach. The expected outcome of this study is high-quality pilot data assessing the efficacy of group prenatal care in women with type 2 and gestational diabetes. If the trial provides evidence that Diabetes CP is effective, data and experience from this study will support the development of an R01 application to test Diabetes CP in a multi-center randomized trial. If the hypothesis that group prenatal care reduces maternal postpartum weight retention is confirmed, the findings will revolutionize diabetes care in the United States. Group prenatal care will be a simple, cost-effective intervention for the increasing numbers of women with diabetes in pregnancy. The training and research activities outlined in this proposal will complement the candidate's background in public health and place her in a unique position to advance our ability to treat women with chronic diseases of pregnancy and improve their long-term health. Ultimately, this work will lead to new, innovative ways of providing prenatal care to women with co-morbid diseases that may impair their health, both during pregnancy and for years to come.

项目摘要/摘要 随着2型糖尿病、妊娠期糖尿病和妊娠期高血压疾病的发病率上升， 产前治疗和产后降低风险对未来心血管不良的挑战 事件。这项以病人为本的辅导职业发展奖(K23)的目的是使 开发一项资助研究计划的候选人，该计划旨在优化医疗合并症的管理 并确定改变女性未来慢性病轨迹的创新方法。要做到这一点 在三个关键领域提出了目标、培训和指导：1)社区高级培训 参与性研究、生物统计学和临床试验，2)保护时间，以病人为中心进行研究 以糖尿病为重点的集体产前护理计划改善产后健康的能力，以及3) 基础研究和对相关数据库的介绍，以促进未来对关系的研究 妊娠并发症和未来心血管疾病之间的关系，以促进下一阶段的研究。 该奖项的研究计划将在培训计划和 由专家导师和顾问组成的跨学科团队。拟议的项目将检验团队的能力 产前糖尿病护理，糖尿病中心妊娠(糖尿病CP)，以改善低收入者的结局 怀孕的患有糖尿病的非裔美国妇女。这些妇女长期患病的风险增加。 心血管疾病，这个项目利用产前的时间来促进健康行为 这可能会延续到产后阶段，从而降低这种风险。具体地说，这个项目将确定 糖尿病CP是否将产妇产后体重滞留减少长达一年。该项目将雇用一名 随机对照设计和严谨、系统的方法。这项研究的预期结果是 评估2型和妊娠期妇女集体产前护理效果的高质量先导数据 糖尿病。如果试验提供了糖尿病CP有效的证据，这项研究的数据和经验将 支持开发R01应用程序，以在多中心随机试验中测试糖尿病CP。如果 小组产前护理减少产妇产后体重滞留的假设得到证实，研究结果 将给美国的糖尿病治疗带来革命性的变化。团体产前护理将是一种简单、成本效益高的 对越来越多的妊娠期糖尿病妇女进行干预。培训和研究 这项提案中概述的活动将补充候选人的公共卫生背景，并将她置于 一个独特的职位，以提高我们治疗慢性妊娠疾病妇女的能力，并改善她们的 长期的健康。最终，这项工作将导致为妇女提供产前护理的新的、创新的方式 患有可能在怀孕期间和未来几年损害她们健康的共病疾病。