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

移动健康应用程序可减少患有妊娠期糖尿病的拉丁女性的糖尿病

• 批准号: 8898581
• 负责人: Dharma E CORTES
• 金额: $ 19.92万
• 依托单位: ENVIRONMENT AND HEALTH GROUP, INC.
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-22 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8898581
• 关键词: Address; Adopted; Adoption; Age; Algorithms; Behavior Therapy; Behavioral; Body Weight decreased; Car Phone; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Communities; Computers; Data; Development; Diabetes Mellitus; Diabetes prevention; Eating; Economics; Education; Effectiveness; English Language; Epidemic; Ethnic Origin; Face; Funding; Future; Gender; Gestational Diabetes; Glosso-Sterandryl; Goals; Health; Hispanic Americans; Hispanics; Internet; Intervention; Knowledge; Language; Latina; Life Style; Modification; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Online Systems; Operating System; Outcome; Participant; Perception; Persons; Phase; Population; Populations at Risk; Pregnancy; Prevention; Race; Randomized; Randomized Clinical Trials; Recording of previous events; Relative Risks; Research; Research Infrastructure; Risk; Sample Size; Schedule; Self Efficacy; Small Business Innovation Research Grant; Solutions; System; Technology; Testing; Text; Time; Translating; United States National Institutes of Health; Weight; Woman; base; behavior change; behavioral health; commercialization; community based care; comparison group; cost effective; diabetes prevention program; diet and exercise; evaluation/testing; evidence base; good diet; health care delivery; health disparity; healthy lifestyle; high risk; improved; infrastructure development; innovation; innovative technologies; lifetime risk; mHealth; mobile application; prevent; primary outcome; randomized trial; reproductive; risk perception; secondary outcome; skills; theories; treatment as usual; usability

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.

描述（由申请人提供）：西班牙裔女性终生患 2 型糖尿病 (T2DM) 的风险最高。对于妊娠合并妊娠糖尿病 (GDM) 的女性来说，存在预防 T2DM 的机会之窗。既往患有 GDM 的女性患 T2DM 的风险增加。西班牙裔女性患 GDM 的风险较高，而患有 GDM 的女性患 T2DM 的相对风险比患有 GDM 的非西班牙裔白人女性更高。美国国立卫生研究院 (NIH) 资助的糖尿病预防计划 (DPP) 记录了改变生活方式对预防 T2DM 的有效性。将 DPP 研究转化为基于社区的环境一直具有挑战性。移动技术的最新发展提供了有前途的解决方案，可以将从实验环境中获得的知识应用于基于社区的护理。拟议的 SBIR 建立在该团队由 CDC 资助的基于互联网、经 GDM 修改的 DPP 的基础上，将是第一个开发和测试交互式、文化和个人定制、简单语言西班牙语/英语移动健康干预措施 (m-intervention) 的项目降低近期患有 GDM 的西班牙裔女性患 T2DM 的风险。移动干预利用了西班牙裔育龄妇女广泛使用移动电话的机会，并提供了克服身体障碍（24/7）、知识障碍（简单西班牙语/英语的教育/技能发展）、基础设施障碍（不使用手机）、经济障碍（负担得起）和文化障碍（文化上可接受）。使用手机来预防患有 GDM 的西班牙裔女性实现了 RFA 的目标……“根据特定健康差异人群的需求重新设计了现有技术”。所提出的系统在技术上具有创新性，使用参与者为自己和他人生成的短信。西班牙语/英语移动应用程序的特点： 根据文化/个人量身定制的教育/励志文本，以改变行为；由算法得出、单独定制的文本，这些文本是 a) 参与者生成的； b) 自动化，基于先前参与者定义的时间表，以及 c) 及时，基于参与者对当前活动的实时输入；和体重跟踪。我们的长期目标是预防这一高危人群患 T2DM。形成性评估测试文本的文化可接受性和应用程序的可用性。一项随机试点试验探讨了该应用程序在健康饮食（主要结果）、减肥（次要结果）和 HBA1C、T2DM 感知风险和修正感知风险（探索性）的自我效能变化方面的有效性。第一阶段的结果将提供数据来确定样本量，以制定/提交 m 干预的第二阶段随机对照试验，以促进健康的生活方式，从而在近期患有 GDM 的西班牙裔女性中实现减肥。移动干预提供了一种可扩展且具有成本效益的方法，可以减少健康差距并改善患有 GDM 的西班牙裔女性的健康结果，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，拟议的应用程序具有广泛的商业化潜力。