Submission
| Title: | A Tailored Approach to Increase Engagement in Lifestyle Change Programs in Women with Previous Gestational Diabetes |
| Presenter: | Julie Pike |
| Institution: | Indiana University School of Medicine |
| Authors: | Julie M. Pike1,2, Kathryn M. Haberlin-Pittz1,2, Luz A. Machuca1, Brett M. McKinney1, Lisa G. Yazel1, Aric Kotarski1, Tamara S. Hannon1,2
1 Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN |
Abstract
| Background/Significance/Rationale: | Women with previous GDM (pGDM) are at increased risk for type 2 diabetes. Yet, engagement of this population in lifestyle change programs is low. We evaluated the effect of a tailored diabetes prevention approach on engagement and health outcomes in women with pGDM. |
| Methods: | This unrandomized cohort study engaged women with pGDM in an informed decision-making process to discuss type 2 diabetes risk, explore preferences for a lifestyle change program, and select a program aligned with individual priorities. Seven evidence-based lifestyle change programs with a variety of delivery modes, duration, time of day, and childcare availability were offered free of charge. The primary outcome was program engagement. Secondary outcomes were psychosocial questionnaires and clinical measures at baseline, 6 months (T1), and 12 months (T2). Statistical analysis included repeated measures ANCOVA. |
| Results/Findings: | We consented 116 women (34.9 ± 5.7 y; 57.3% white; college degree 47.3%). Ninety-two participants were included in data analysis after exclusions due to pregnancy (n=9), baseline BMI <25 (n=11), baseline HbA1c ≥6.5 (n=3), and illness (n=1). Almost half selected WW (41%), followed by Habit Nu (22%), health coaching (11%), Encourage (10%), the dietitian consult (9%), Healthy Me (5%), and the YMCA NDPP (1%). Most participants who selected WW (84%) remained engaged in the study at T1 and/or T2. BMI, HbA1c, and questionnaires were stable from baseline to T1 and T2. |
| Conclusions/Discussion: | A tailored diabetes prevention strategy is feasible and acceptable in women with pGDM, even during the COVID-19 pandemic and shutdown, which impacted the outcomes. Lifestyle change programs that meet the unique priorities and needs of women with pGDM are needed to optimize engagement and outcomes. |
| Translational/Human Health Impact: | Offering a choice of lifestyle change programs and completing program enrollment at the time of type 2 diabetes risk discussion may enhance engagement in diabetes prevention efforts among women with pGDM. |
