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

基本信息

批准号：
10224882
负责人：
Ebony Boyce Carter
金额：
$ 15.06万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10224882
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 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

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 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

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项目摘要

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.

项目摘要/摘要随着2型糖尿病的发生率，妊娠糖尿病和怀孕的高血压疾病，因此为将来的不良心血管造成天前治疗和产后风险的挑战事件。这个受过指导的以患者为导向的职业发展奖（K23）的目的是使候选人制定一项资助的研究计划，以优化医疗合并症的管理怀孕并确定改变女性未来慢性疾病轨迹的创新方法。实现这一目标目标，培训和指导是在三个关键领域提出的：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）保护针对患者的研究时间以团体糖尿病为中心的产前护理计划改善产后健康的能力，3）基础研究和对相关数据库的介绍，以促进对关系的未来研究在怀孕并发症和未来心血管疾病之间，以促进下一阶段的研究。该奖项的研究计划将在培训计划的支持下实施跨学科的专家导师和顾问团队。拟议的项目检查了小组的能力产前糖尿病护理，糖尿病居中妊娠（糖尿病CP），以改善低收入的预后怀孕的非裔美国妇女患有糖尿病。这些妇女有发展的长期风险心血管疾病，该项目利用产前时期来促进健康行为这可能会延续到产后时期，从而降低这种风险。具体来说，这个项目将确定糖尿病CP是否可以将产后保留量减少到一年。该项目将采用随机控制设计和严格的系统方法。这项研究的预期结果是高质量的试验数据评估组产前护理在2型和妊娠的女性中的功效糖尿病。如果该试验提供了糖尿病CP有效的证据，那么本研究的数据和经验将支持在多中心随机试验中开发R01应用程序以测试糖尿病CP。如果是假设群体产前护理减少了母体产后体重的保留，这是发现结果将彻底改变美国的糖尿病护理。团体产前护理将是一个简单，成本效益的妊娠糖尿病女性人数增加的干预措施。培训和研究该提案中概述的活动将补充候选人的公共卫生背景，并将其放置一个独特的立场，可以提高我们治疗慢性怀孕妇女的能力并改善她们的能力长期健康。最终，这项工作将导致为妇女提供产前护理的新的创新方法在怀孕期间和未来几年中，合并症可能会损害其健康状况。