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Avoiding Diabetes After Pregnancy Trial (ADAPT)

14. august 2013 oppdatert av: Social & Scientific Systems Inc.

Increasing Adoption of Early Intervention to Prevent Diabetes After Gestational Diabetes Mellitus

The Avoiding Diabetes After Pregnancy Trial (ADAPT) study was designed to test the effectiveness of interventions that potentially increase the adoption of Diabetes Prevention Program (DPP) elements by women who had a pregnancy with gestational diabetes mellitus (GDM).

The study was conducted as an integrated trial with two separate arms: one to facilitate weight reduction and the other to increase diabetes testing.

There were two hypotheses:

  1. Women in the testing intervention will be more likely to have received a diabetes test within the 6 months post-intervention than women in the control group.
  2. Women in the weight reduction intervention will have lost more weight at the 6-month and 9-month follow-up than women in the control group.

The primary study aim was to determine the efficacy of a system of interactive technology-based supports to prompt women with a history of gestational diabetes to take steps to prevent diabetes. The secondary aims were focused on women's engagement:

  • To evaluate the impact of the weight reduction intervention in terms of participant engagement with the interactive technology-based supports.
  • To evaluate changes in the women's perception of their personal diabetes risk following after exposure to information about diabetes risk following a pregnancy with GDM.
  • To identify the determinants and motivators of and barriers to diabetes testing in the 6- to 12-week postpartum period and thereafter, using the Health Belief model to guide the study.

There was an additional secondary aim involving metformin:

  • To evaluate the impact of the diabetes risk reduction intervention in terms of women seeking out their physician's advice on metformin treatment and receiving a metformin prescription, if appropriate.

Studieoversikt

Studietype

Intervensjonell

Registrering (Faktiske)

140

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Maryland
      • Silver Spring, Maryland, Forente stater, 20910
        • Social & Scientific Systems Inc.

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Hunn

Beskrivelse

Inclusion Criteria:

General

  • History of GDM in the previous 6 months to 4.5 years
  • Access to the internet and text messages or phone messages
  • Current patient of Harvard Vanguard Medical Associates
  • 18 years of age or older
  • Able to read in English

Weight Reduction Group

  • Overweight or obese
  • Capable of performing moderate physical activity

Diabetes Testing Group

  • Had not competed a diabetes test (OGTT or fasting blood sugar at 6-12 weeks postpartum or OGTT, fasting blood sugar or hemoglobin A1c after 12 weeks postpartum)

Exclusion Criteria:

General:

  • Diabetes diagnosis
  • Psychotic disorder diagnosis
  • Enrolled in a research study

Weight Reduction Group

  • Taking prescription medications for weight loss
  • Engaged in a formal weight reduction program

Diabetes Testing Group

  • History of postpartum OGTT, fasting plasma glucose or hemoglobin A1c (after 6 weeks postpartum)

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Weight Reduction Intervention

The weight trial intervention components were:

  • Electronic feedback from the ADAPT interactive obesity treatment approach (iOTA) system, tracking participants' behavior change goals. Participants received feedback either by daily SMS (text messaging) or by weekly IVR (interactive automated calls).
  • Seven behavior change coaching calls, once a month for 6 months, and then one at 7.5 months halfway through the maintenance period.
  • Print mailings/emailings
  • 3 Get Ready e-messages in the four weeks before the weight intervention began
  • Pedometers and program guides. (IVR users received printed activity logs with their program guides.)
  • Access to the ADAPT iOTA website for reviewing their progress and obtaining information on behavior change goals.
Aktiv komparator: Weight Reduction Control Arm
Participants received an initial brochure about managing diabetes risk, a digital scale to use in entering their weights in online questionnaires, and monthly emailed wellness messages unrelated to diabetes.
Aktiv komparator: Tested for diabetes
Due to small numbers in this group, the planned intervention was changed to a mixed-mode study, using baseline and follow-up self-administered questionnaires and semi-structured questionnaires administered to a sub-sample of those tested for diabetes to identify factors differentiating the behavior of women who had and had not been tested for diabetes following a pregnancy with gestational diabetes mellitus.
Aktiv komparator: Not tested for diabetes
Due to small numbers in this group, the planned intervention was changed to a mixed-mode study, using baseline and follow-up self-administered questionnaires and semi-structured questionnaires administered to a subsample of those not tested for diabetes to identify factors differentiating the behavior of women who had and had not been tested for diabetes following a pregnancy with gestational diabetes mellitus.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
For participants in weight group, weight reduction from baseline to 6 months
Tidsramme: 6 months
Participants reported their weights online at baseline, 3 months, 6 months, and 9 months, and the difference in weight from baseline to 6 months was the primary measure of the intervention's success.
6 months
In testing group, the number of women receiving a diabetes test per ADA Guidelines in the 6-month post-intervention period
Tidsramme: 6 months
The number of women who were tested in the 6 months following the intervention was determined from electronic medical records.
6 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Weight intervention participant engagement with the interactive technology-based supports
Tidsramme: 9 months
Measured by separate scores for taking part in behavioral support (coaching calls) and electronic feedback (women responding on goal performance via daily text messaging (SMS)or weekly IVR, chosen by the participant).
9 months
Success of participants in weight intervention arm in achieving behavior change goals.
Tidsramme: 9 months
Information from daily SMS and weekly IVR responses to questions about participants' success in achieving behavior change goals were used to construct achievement scores.
9 months
Weight change from baseline to 9 months
Tidsramme: 9 months
Differences were calculated in weights entered on baseline and 9-month surveys for intervention and control arms in the weight group.
9 months
Weight change from 6 to 9 months
Tidsramme: 3 months
Difference in weights recorded in 6-month and 9-month questionnaires was calculated for all participants in the weight group.
3 months

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Hovedetterforsker: Susan J Griffey, DPh, BSN, Social & Scientific Systems Inc.

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. desember 2011

Primær fullføring (Faktiske)

1. mars 2013

Studiet fullført (Faktiske)

1. mars 2013

Datoer for studieregistrering

Først innsendt

13. august 2013

Først innsendt som oppfylte QC-kriteriene

14. august 2013

Først lagt ut (Anslag)

15. august 2013

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

15. august 2013

Siste oppdatering sendt inn som oppfylte QC-kriteriene

14. august 2013

Sist bekreftet

1. august 2013

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • NDEP-GDM GS10F0381L
  • GS10F0381L (Annet stipend/finansieringsnummer: GSA)

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