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

描述（由申请人提供）：西班牙裔女性一生中患2型糖尿病（T2DM）的风险最高。妊娠合并妊娠期糖尿病（GDM）的妇女存在预防2型糖尿病的机会窗口。既往有GDM的女性患2型糖尿病的风险增加。西班牙裔女性患GDM的风险增加，与非西班牙裔白人女性相比，患有GDM的女性患2型糖尿病的相对风险更高。美国国立卫生研究院资助的糖尿病预防项目（DPP）记录了改变生活方式预防2型糖尿病的有效性。将民进党研究转化为社区环境是一项挑战。移动技术的最新发展为将从实验环境中获得的知识应用于社区护理提供了有希望的解决方案。拟议的SBIR建立在该团队由cdc资助的基于互联网的GDM修改DPP的基础上，将是第一个开发和测试一种互动的、文化上和个人量身定制的、简单语言的西班牙语/英语移动健康干预（m-干预），以降低近期患有GDM的西班牙裔妇女患2型糖尿病的风险。m-干预利用了西班牙育龄妇女对移动电话的广泛采用，并提供了克服物理障碍（24/7无障碍）、知识障碍（普通西班牙语/英语教育/技能发展）、基础设施障碍（不使用移动电话）、经济障碍（负担得起）和文化障碍（文化上可接受）的机会。使用手机预防既往患有GDM的西班牙裔女性的2型糖尿病实现了RFA的目标。“根据特定健康差异人群的需求重新设计的现有技术。”拟议中的系统在技术上是创新的，它使用参与者为自己和他人生成的短信。西班牙语/英语移动应用程序功能：为行为改变量身定制的文化/个性化教育/激励文本；算法衍生的、个性化定制的文本，a)参与者生成；B)自动的，基于参与者事先定义的时间表；c)及时的，基于参与者对当前活动的实时输入；还有体重追踪。我们的长期目标是在高危人群中预防2型糖尿病。形成性评估测试了文本的文化可接受性和应用程序的可用性。一项试点随机试验探讨了应用程序在健康饮食（主要结果）、减肥（次要结果）、HBA1C、T2DM感知风险和修改感知风险（探索性）方面的有效性变化。I期结果将提供数据，以确定开发/提交m干预的II期RCT的样本量，以促进健康的生活方式，以实现近期患有GDM的西班牙裔妇女的体重减轻。m-干预提供了一种可扩展且具有成本效益的方法，可减少近期GDM的西班牙裔妇女的健康差异，并改善其健康结果，这是一个高风险但服务不足的群体。鉴于医疗保健服务的变化，拟议的应用具有广泛的商业化潜力。

DESCRIPTION (provided by applicant): Hispanic women have the highest lifetime risk for type 2 diabetes (T2DM). A window of opportunity for preventing T2DM exists for women with pregnancies complicated by gestational diabetes mellitus (GDM). Women with prior GDM face increased risk of T2DM. Hispanic women are at increased risk of GDM, and those with GDM have higher relative risks for developing T2DM than non-Hispanic white women with GDM. The NIH-funded Diabetes Prevention Program (DPP) documented the effectiveness of lifestyle modification to prevent T2DM. Translating DPP research into community-based settings has been challenging. Recent development of mobile technologies offers promising solutions to taking knowledge obtained from experimental settings into community-based care. The proposed SBIR, building on the team's CDC-funded internet-based, GDM-modified DPP, would be the first to develop and test an interactive, culturally and individually-tailored, plain languae Spanish/English mobile health intervention (m-intervention) to reduce risk of T2DM for Hispanic women with recent GDM. The m-intervention leverages the widespread adoption of mobile phones in Hispanic women of reproductive age, and affords the opportunity to overcome physical barriers (accessible 24/7), knowledge barriers (education/skills development in plain Spanish/English), infrastructure barriers (not present using mobile phones), economic barriers (affordable), and cultural barriers (culturally acceptable). Using mobile phones to prevent T2DM in Hispanic women with prior GDM addresses the RFA's goal for..."existing technologies that have been redesigned based on the needs of a specific health disparity population." The proposed system is technologically innovative using participant-generated text messages for themselves as well as others. The Spanish/English mobile app features: culturally/individually tailored educational/motivational texts for behavioral change; algorithm-derived, individually tailored texts that are a) participant generated; b) automated, based on prior participant-defined schedule, and c) just in-time, based on real time participant input about current activities; and weight tracking. Our long-term goal is the prevention of T2DM in this at-risk population. Formative evaluations test the cultural acceptability of the texts and the usability of the app. A pilot randomized trial explores effectiveness of the app in changes in self-efficacy for healthy eating (primary outcome), weight loss (secondary outcome), and HBA1C, perceived risk for T2DM, and modified perceived risk (exploratory). Phase I results will provide data to determine sample size for the development/submission of a Phase II RCT of the m-intervention to promote healthy lifestyle to achieve weight loss among Hispanic women with recent GDM. The m-intervention offers potential of a scalable and cost-effective approach to decreasing health disparities and to improving health outcomes in Hispanic women with recent GDM, a high-risk, yet underserved group. The proposed application has broad commercialization potential given changes in health care delivery.