SAT-122 A Mobile App to Decrease Risk Factors for Diabetes in Women with Recent GDM

Abstract

BACKGROUND: Latinas have one of the highest rates of gestational diabetes mellitus (GDM) in the US. GDM is a major risk factor for type 2 diabetes (T2DM), with up to 60% of women developing T2DM after GDM. Latinos are one of the largest US minority groups, providing impetus for developing lifestyle interventions for this population. The potential to prevent T2DM, including in women with remote GDM, was demonstrated by the Diabetes Prevention Program. However, helping women with recent GDM make behavioral changes needed to decrease risk is a challenge given barriers women with young families face participating in in-person programs. The increasing ubiquity of mobile phone use among Latinos, and rising interest in mobile technologies to deliver healthcare interventions offer the means to overcome these barriers. METHODS: We developed and tested preliminary efficacy of a bilingual (Spanish/English), culturally sensitive, android-based app (¡Hola Bebe, Adios Diabetes!) for promoting healthy lifestyle in obese/overweight Latinas with recent GDM (within 5 years) to reduce risk factors for T2DM in an 8-week trial. Self-efficacy for healthy eating and physical activity (primary outcomes) and weight (secondary outcome) were determined at baseline and study end. The app provided education about health eating and physical activity, action planning, weight tracking, exercise videos, a community forum and motivational text messaging. Achievement in behaviors (e.g., tracking weight) was recognized by badges. RESULTS: We approached 30 women with self-reported Latina ethnicity and recent GDM documented in the medical record within 5 years; 21 provided informed consent and enrolled. Participants were 33 ± 7 (mean±SD) years old and 3 ± 0.7 years from their GDM pregnancy and 14 (64%) reported family history of T2DM. 18 of 21 women (82%) completed the 8-week study providing pre-post data. Self-efficacy for physical activity increased significantly from pre to post (P=.003), self-efficacy for healthy eating increased with borderline significance (P=.059), and weight decreased significantly by 1.5 lbs (P=.003). Backend data revealed a high engagement rate: 91% (19/21) of participants viewed modules/created action plans; 95% (20/21) earned badges by completing a learning module/action plan or weighing. Many posted on the community forum tips for other participants such as a family recipe. Structured interviews with participants revealed that they especially liked the personalized action plans, motivational messages, at-home exercise videos, and recipes. A suggestion for enhancement included adding an “ask the expert” feature to the community forum. CONCLUSION: The ¡Hola Bebe, Adios Diabetes! app was usable and well accepted by Latinas with recent GDM and showed preliminary effectiveness. This program will be tested in a larger, longer randomized trial.*Supported by NIH SBIR grant.