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

DESCRIPTION provided by applicant Hispanic women have the highest lifetime risk for type diabetes T DM A window of opportunity for preventing T DM exists for women with pregnancies complicated by gestational diabetes mellitus GDM Women with prior GDM face increased risk of T DM Hispanic women are at increased risk of GDM and those with GDM have higher relative risks for developing T DM than non Hispanic white women with GDM The NIH funded Diabetes Prevention Program DPP documented the effectiveness of lifestyle modification to prevent T DM 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 teamandapos 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 T DM 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 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 T DM in Hispanic women with prior GDM addresses the RFAandapos s goal for andquot existing technologies that have been redesigned based on the needs of a specific health disparity population andquot 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 T DM 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 HBA C perceived risk for T DM 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 PUBLIC HEALTH RELEVANCE The proposed study effort will develop assess and test an innovative mobile phone based adaptation of the Diabetes Prevention Project to promote self efficacy and behavioral change among Hispanic women with prior gestational diabetes mellitus GDM with the goal of preventing Type diabetes mellitus T DM in this population The approach used in this culturally tailored health behavioral theory guided and technology based mobile intervention has the potential to improve health outcomes by helping Hispanic women with a history of GDM an underserved group at a uniquely high risk of developing T DM adopt lifestyle changes i e healthy diet exercise that may help protect them against future T DM