Reach, acceptability, and perceived success of a telehealth diabetes prevention program among racially and ethnically diverse patients with gestational diabetes: the GEM cluster-randomized trial.

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  • Additional Information
    • Source:
      Publisher: Oxford University Press Country of Publication: England NLM ID: 101554668 Publication Model: Print Cited Medium: Internet ISSN: 1613-9860 (Electronic) Linking ISSN: 16139860 NLM ISO Abbreviation: Transl Behav Med Subsets: MEDLINE
    • Publication Information:
      Publication: 2018- : [Oxford] : Oxford University Press
      Original Publication: New York : Springer
    • Subject Terms:
      Diabetes Mellitus, Type 2*/prevention & control ; Diabetes, Gestational*/prevention & control ; Telemedicine*; Ethnicity ; Female ; Humans ; Minority Groups ; Pregnancy ; United States
    • Abstract:
      Patients with gestational diabetes mellitus and from racial/ethnic minority groups face disproportionate risk for type 2 diabetes. Lifestyle interventions, if accessible and acceptable to diverse patients, could advance diabetes prevention and mitigate racial/ethnic disparities. Here we describe overall and race/ethnicity-specific reach, acceptability, and perceived success from an effective telehealth diabetes prevention lifestyle program for patients with gestational diabetes mellitus, implemented in the Gestational Diabetes Effects on Moms (GEM) cluster-randomized controlled trial. GEM tested a program of 13 telephone sessions and behavior change techniques (BCTs, e.g., goal setting) in a healthcare system. We evaluated participation (completing ≥1 session), acceptability of BCTs, and perceived success reaching program goals. Among 1,087 patients (75.2% from minority groups), 50.3% participated. Participation rates were 61.7% among Black, 56.4% among Hispanic, 55.6% among multiracial/other, 53.0% among White, and 43.7% among Asian/Pacific Islander patients. Evaluation survey respondents (n = 433/547; 79.2%) largely rated BCTs as very helpful (range 40.9%-58.4%) or moderately helpful (27.3%-34.9%). Respondents from minority groups largely rated goal setting for weight management as very or moderately helpful, with fewer minority respondents rating it as only a little/not at all helpful than White respondents (p = .02). Black and White respondents reported more limited success reaching a healthy weight than Asian/Pacific Islander, Hispanic, and multiracial/other women (p = .005). A telehealth diabetes prevention lifestyle program demonstrated reach and acceptability across racial/ethnic groups. While perceived success can be improved among Black and White participants, such programs could promote access to preventive care and help mitigate disparities in diabetes risk.
      (© Society of Behavioral Medicine 2022. All rights reserved. For permissions, please e-mail: [email protected].)
    • References:
      J Consult Clin Psychol. 2013 Apr;81(2):336-46. (PMID: 23106759)
      Ann N Y Acad Sci. 2020 Feb;1461(1):5-24. (PMID: 31793006)
      Diabetes Care. 2018 Jul;41(7):1370-1377. (PMID: 29669736)
      BMC Pregnancy Childbirth. 2014 Jan 15;14:21. (PMID: 24423410)
      J Clin Endocrinol Metab. 2008 Dec;93(12):4774-9. (PMID: 18826999)
      Med Care. 2019 Jul;57(7):528-535. (PMID: 31107396)
      Diabetes Care. 2017 Oct;40(10):1331-1341. (PMID: 28500215)
      Womens Health Rep (New Rochelle). 2021 Apr 27;2(1):106-112. (PMID: 33937908)
      JAMA Netw Open. 2019 May 3;2(5):e193160. (PMID: 31074808)
      Ethn Dis. 1999 Winter;9(1):10-21. (PMID: 10355471)
      Diabetologia. 2011 Dec;54(12):3016-21. (PMID: 22016046)
      Diabetes Care. 2016 Jan;39(1):65-74. (PMID: 26657945)
      J Womens Health (Larchmt). 2011 Feb;20(2):239-45. (PMID: 21265645)
      Adm Policy Ment Health. 2011 Mar;38(2):65-76. (PMID: 20957426)
      Diabetes Care. 2020 Nov 2;:. (PMID: 33139407)
      Am J Prev Med. 2021 Oct;61(4):606-617. (PMID: 34544560)
      JAMA. 2021 Aug 17;326(7):660-669. (PMID: 34402831)
      J Gen Intern Med. 2001 Sep;16(9):606-13. (PMID: 11556941)
    • Grant Information:
      P30 DK092924 United States DK NIDDK NIH HHS; R01 HS019367 United States HS AHRQ HHS; R03 DK113325 United States DK NIDDK NIH HHS
    • Contributed Indexing:
      Keywords: Gestational diabetes; Implementation; Lifestyle intervention; Program evaluation; Type 2 diabetes prevention
    • Publication Date:
      Date Created: 20220718 Date Completed: 20220721 Latest Revision: 20230719
    • Publication Date:
      20231215
    • Accession Number:
      PMC9291385
    • Accession Number:
      10.1093/tbm/ibac019
    • Accession Number:
      35849139