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: 10480742
• 负责人: Ebony Boyce Carter
• 金额: $ 15.09万
• 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 2023-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10480742
• 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; Complement; Contraceptive methods; Data; Databases; Development; Diabetes Mellitus; Disease; Dystocia; Education; Enrollment; Event; Exercise; Foundations; Funding; Future; Gestational Age; Gestational Diabetes; Glucose; Glycosylated hemoglobin A; Goals; Habits; Health; Health Promotion; Hematocrit procedure; Hypertension; 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; Obesity Epidemic; 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; comorbidity; cost effective intervention; diabetic patient; dietary control; experience; follow-up; glycemic control; improved; improved outcome; innovation; lifetime risk; maternal outcome; maternal weight; neonatal outcome; obesity development; obesity risk; patient oriented; patient oriented research; postpartum health; postpartum weight; pregnancy disorder; pregnant; prenatal; programs; psychosocial; randomized controlled design; 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.

项目概要/摘要 随着 2 型糖尿病、妊娠糖尿病和妊娠高血压疾病的发病率上升， 应对产前治疗和产后降低未来不良心血管风险的挑战 事件。该以患者为导向的职业发展奖（K23）的目的是使 候选人开发一项资助的研究计划，以优化期间医疗共病的管理 怀孕并确定改变女性未来慢性病轨迹的创新方法。为了实现这一目标 在三个关键领域提出了目标、培训和指导： 1) 基于社区的高级培训 参与性研究、生物统计学和临床​​试验，2) 进行以患者为导向的研究的受保护时间 以糖尿病为重点的团体产前护理计划改善产后健康的能力，以及 3) 基础研究和相关数据库介绍，以促进未来的关系研究 妊娠并发症和未来心血管疾病之间的关系，以促进下一阶段的研究。 该奖项的研究计划将在培训计划和 由专家导师和顾问组成的跨学科团队。拟议项目检验小组的能力 产前糖尿病护理、以妊娠为中心的糖尿病 (Diabetes CP)，以改善低收入人群的结局 患有糖尿病的非洲裔美国孕妇。这些女性患上这种疾病的长期风险增加 心血管疾病，该项目利用产前期促进健康行为 这可能会延续到产后期，从而降低这种风险。具体来说，本项目将确定 糖尿病 CP 是否可以减少母亲产后体重滞留长达一年的时间。该项目将聘用一名 随机对照设计和严格、系统的方法。这项研究的预期结果是 评估团体产前护理对 2 型和妊娠期妇女的功效的高质量试点数据 糖尿病。如果试验提供证据表明糖尿病 CP 是有效的，那么本研究的数据和经验将 支持开发 R01 应用程序，以在多中心随机试验中测试糖尿病 CP。如果 团体产前护理可减少母亲产后体重滞留的假设得到证实，研究结果 将彻底改变美国的糖尿病护理。团体产前护理将是一种简单、经济高效的方法 对越来越多的妊娠期糖尿病妇女进行干预。培训与研究 本提案中概述的活动将补充候选人在公共卫生方面的背景，并将她置于 具有独特的地位，可以提高我们治疗患有妊娠期慢性疾病的妇女的能力，并改善她们的健康状况 长期健康。最终，这项工作将带来为女性提供产前护理的创新方法 患有可能损害其健康的共病，无论是在怀孕期间还是在未来几年。

项目成果

Adverse Pregnancy Outcomes and Postpartum Care as a Pathway to Future Health.

• DOI: 10.1097/grf.0000000000000724
• 发表时间: 2022-09-01
• 期刊: CLINICAL OBSTETRICS AND GYNECOLOGY
• 影响因子: 1.5
• 作者: Barry, Valene Garr;Johnson, Traci N.;Herrick, Cynthia;Lindley, Kathryn;Carter, Ebony B.
• 通讯作者: Carter, Ebony B.

The Impact of Group Prenatal Care on Interpregnancy Interval.

团体产前护理对妊娠间隔的影响。

• DOI: 10.1055/s-0041-1739413
• 发表时间: 2023
• 期刊: American journal of perinatology
• 影响因子: 2
• 作者: Keller,JustineM;Norton,JessicaA;Zhang,Fan;Paul,Rachel;Madden,Tessa;Raghuraman,Nandini;Stout,MollyJ;Carter,EbonyB
• 通讯作者: Carter,EbonyB