Gestational Diabetes, Pregnancy in Diabetics
Conditions
Brief summary
Diabetes during pregnancy can be a challenging circumstance requiring extensive patient learning and self-care. The purpose of this study is to develop and pilot test a patient-centered diabetes education and self-care tool using text messaging to provide supportive messaging and education to underserved women with a pregnancy complicated by diabetes.
Detailed description
Low-income, pregnant women in the Chicago area are frequently affected by obesity or diabetes. The addition of a disease in pregnancy amplifies the requirements for optimal self-care during pregnancy. This load of information poses a significant burden, particularly for women with additional socioeconomic barriers to self-care. Preliminary work suggests patients must overcome a number of social, psychological, and knowledge-based barriers to achieve successful diabetic control in pregnancy. This project involves development and preliminary evaluation of a patient-centered education and self-care tool for use with women whose pregnancies are complicated by diabetes. The study begins with development of a text messaging curriculum to provide motivational and educational support. We will use a one-way, non-interactive text-based educational platform to provide supportive and educational messages to a cohort of 40 women with diabetes. Women receive 3-5 text messages per week until delivery. The goal is to develop a program that can be expanded to a clinical trial in which perinatal outcomes are assessed. The primary outcome is patient satisfaction and opinions about the texting program, as measured via a qualitative interview upon study completion. Participants underwent an enrollment survey to assess health literacy/numeracy, diabetes self-efficacy, diabetes knowledge, personality, and social hassles. They underwent a baseline in-depth one-on-one interview focusing on barriers to successful self-care with pregnancy and diabetes. Follow-up surveys and an exit interview elicited information about their opinions of the texting program. Additional goals included determining feasibility for future expansion as a trial.
Interventions
BEHAVIORALTexting group
Women receive text messages to aid in their diabetes self-care tasks during pregnancy; these included appointment reminders, motivational messages, and nutrition/exercise tips.
Sponsors
Northwestern University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Intervention model description
Single arm feasibility and pilot testing study of a curriculum
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Pregnant * English-speaking * Have gestational diabetes mellitus, type 2 diabetes mellitus, or type 1 diabetes mellitus * Age 18 years or older * Access to a phone that can receive text messages
Exclusion criteria
* Gestational age greater than 30 weeks * Women not meeting the above inclusion criteria
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient satisfaction and feedback | Up to 42 weeks | A single qualitative interview of patient perspectives and areas for improvement in the text messaging program. Interview takes place between 35 weeks gestation and discharge after delivery (postpartum day 2) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diabetes self-efficacy (Measured using the Diabetes Empowerment Scale-Short Form) | Up to 42 weeks | Assessment of diabetes self-efficacy. Survey takes place after 35 weeks gestation and before discharge after delivery (postpartum day 2) |
| Barriers and facilitators of diabetes self-management | Study enrollment | Qualitative interview of patient experiences regarding having diabetes during pregnancy |
| Study feasibility (as measured by number of participants retained in the study) | Up to 42 weeks | Ability to recruit and retain participants |
| Diabetes self-efficacy (Measured using the Perceived Diabetes Self-Management Scale) | Up to 42 weeks | Assessment of diabetes self-efficacy. Survey takes place after 35 weeks gestation and before discharge after delivery (postpartum day 2) |
Outcome results
None listed