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: 9505548
• 负责人: Ebony Boyce Carter
• 金额: $ 15.12万
• 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/9505548
• 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; Comorbidity; Complement; Contraceptive methods; Data; Databases; Development; Diabetes Mellitus; Disease; Dystocia; Education; Enrollment; Epidemic; 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; 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; cost effective; design; diabetic patient; dietary control; effective intervention; experience; follow-up; glycemic control; improved; improved outcome; innovation; lifetime risk; maternal weight; neonatal outcome; obesity development; obesity risk; patient oriented; patient oriented research; postpartum weight; pregnancy disorder; pregnant; prenatal; programs; psychosocial; 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.

项目总结/文摘