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

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: 9806892
• 负责人: Dharma E CORTES
• 金额: $ 48.24万
• 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 2021-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9806892
• 关键词: Achievement; Address; Age; Body Weight decreased; Centers for Disease Control and Prevention (U.S.); Communities; Counseling; Country; Data Analytics; Databases; Development; Diabetes Mellitus; Diagnosis; Effectiveness; Ensure; Equilibrium; Exercise; Feedback; Female; First Pregnancy Trimester; Funding; Future; Gestational Diabetes; Glucose Intolerance; Glycosylated hemoglobin A; Health; Healthy Eating; Hispanics; Home environment; Intervention; Latina; Latino; Life Style; Life Style Modification; Minority Groups; Mobile Health Application; Modeling; Motivation; Music; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Obesity Epidemic; Online Systems; Participant; Patients; Phase; Physical activity; Population; Postpartum Period; Pregnancy; Preventive; Preventive Intervention; Preventive care; Program Acceptability; Provider; Recipe; Recommendation; Recording of previous events; Reporting; Resources; Risk; Risk Factors; Self Efficacy; Small Business Innovation Research Grant; Suggestion; System; Technology; Testing; Text Messaging; Time; Translating; United States; Weight; Woman; Women' s Health; base; child bearing; cost; ethnic disparity; ethnic minority population; evidence base; girls; health disparity; health management; healthy lifestyle; healthy weight; improved; intervention program; medically underserved population; mobile application; modifiable risk; population health; primary outcome; programs; response; secondary outcome; success; trend

Abstract Despite Latinos being the largest ethnic minority, with almost 56.5 million latinos living in the US, they are one of the most medically underserved groups. Latina women have one of the highest rates of gestational diabetes mellitus (GDM) in the U.S. Moreover, GDM is a major risk factor for type 2 diabetes (T2DM), with up to 60% of women developing T2DM within 10 years of a GDM pregnancy. Given the growing obesity epidemic, rates of GDM and T2DM are likely to increase in the absence of preventive interventions. Addressing the risk of T2DM after GDM is critical to reducing health disparities faced by Latina women. The postpartum period is widely-recognized as representing a “window of opportunity” to improve the future health of women who have had complicated pregnancies, including GDM. However, delivery of preventive interventions is challenging due to systems-related factors, including lack of time and resources for providers to provide lifestyle modification counseling, as well as patient challenges, including multiple demands of the postpartum period leaving little time for women to engage in preventive activities. Technology can help overcome these barriers, as demonstrated by the success of our web-based CDC-funded Balance after Baby (BAB) intervention, which successfully promoted weight loss in women with recent GDM. Qualitative results from BAB, which revealed that women strongly wanted the program delivered via an app, led us, in partnership with Latina women with recent GDM, to develop a Phase I m-health intervention program for Latina women, called ¡Hola Bebé, Adiós Diabetes!, in which we tested the preliminary effectiveness of a mobile app in reducing risk factors for the development of T2DM in Latina women who had GDM in the prior 5 years. The proposed Phase II application builds on the promising Phase I results which showed acceptability of the program, increased self-efficacy for healthy lifestyle and weight loss in Latina women with recent GDM. Phase II Specific Aims are as follows: Aim 1: Enhance Hola Bebé to include: a) an IOS version b) integrated databases and data analytics to enable population health management and reporting c) expanded content based on Phase I participant recommendations. Aim 2: Evaluate the effectiveness of Hola Bebé in RCT with Latina women with recent GDM. We hypothesize that participants receiving Hola Bebé will show: increased self-efficacy for healthy eating and physical activity (Primary Outcomes), greater weight loss (Secondary Outcomes), and a greater decrease in HbA1C levels (Exploratory hypothesis) compared to controls. Successful achievement of study aims will result in a culturally tailored, user-centered, low-cost, high- reach, and easy to use evidence-based m-health intervention to reduce risk factors for T2DM in Latina women with a recent history of GDM. The intervention can help reduce the stark ethnic disparities in T2DM among the Latino population while providing a model for an m-health solution that addresses the many systems-based, time, and cost barriers to preventive care typically seen in community-based settings.

摘要 尽管拉丁裔是最大的少数民族，有近5650万拉丁裔生活在美国， 是最缺乏医疗服务的群体之一拉丁裔女性的妊娠率最高， 此外，GDM是2型糖尿病（T2 DM）的主要危险因素， 60%的女性在GDM妊娠10年内发生T2 DM。考虑到肥胖症的流行， 在缺乏预防干预的情况下，GDM和T2 DM的发病率可能会增加。应对风险 GDM后的T2 DM对减少拉丁妇女面临的健康差距至关重要。 产后期被广泛认为是改善妊娠的“机会之窗”。 有复杂妊娠的妇女未来的健康，包括GDM。然而，交付 由于与系统有关的因素，包括缺乏时间和资源， 提供者提供生活方式改变咨询，以及患者的挑战，包括多种需求 妇女产后几乎没有时间从事预防活动。技术可以帮助 克服这些障碍，正如我们基于网络的CDC资助的婴儿后平衡的成功所证明的那样 (BAB)干预，成功地促进了近期GDM妇女的体重减轻。定性结果 BAB透露，女性强烈希望通过应用程序提供该计划，并领导我们合作 与最近患有GDM的拉丁妇女合作，为拉丁妇女制定第一阶段的移动健康干预计划， 叫做“你好贝贝，再见糖尿病！”我们测试了一个移动的应用程序的初步效果， 降低在过去5年内患有GDM的拉丁裔女性发生T2 DM的风险因素。的 拟议的第二阶段应用建立在有希望的第一阶段结果的基础上，这些结果表明， 计划，增加健康生活方式的自我效能和最近GDM的拉丁妇女减肥。相 二.具体目标如下：目标1：加强Hola Bebé，包括：a）IOS版本B） 数据库和数据分析，以便进行人口健康管理和报告c）扩大内容 根据第一阶段参与者的建议。目的2：评价Hola Bebé在RCT中的有效性， 最近患有GDM的拉丁女性。我们假设接受Hola Bebé的参与者将显示： 健康饮食和体力活动的自我效能（主要结局），更大的体重减轻（次要结局 与对照组相比，HbA 1C水平下降幅度更大（探索性假设）。 学习目标的成功实现将导致一个文化定制，以用户为中心，低成本，高， 覆盖面广，易于使用循证移动健康干预措施，以减少拉丁妇女T2 DM的风险因素 最近有过妊娠期糖尿病史干预措施可以帮助减少T2 DM患者中明显的种族差异， 拉丁裔人口，同时提供了一个模型的移动医疗解决方案，解决了许多基于系统， 时间和成本障碍，预防保健通常在社区为基础的设置。