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Avoiding Diabetes After Pregnancy Trial (ADAPT)

14 de agosto de 2013 atualizado por: 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.

Visão geral do estudo

Tipo de estudo

Intervencional

Inscrição (Real)

140

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

    • Maryland
      • Silver Spring, Maryland, Estados Unidos, 20910
        • Social & Scientific Systems Inc.

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Fêmea

Descrição

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)

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Prevenção
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Solteiro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 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.
Comparador Ativo: 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.
Comparador Ativo: 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.
Comparador Ativo: 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.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
For participants in weight group, weight reduction from baseline to 6 months
Prazo: 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
Prazo: 6 months
The number of women who were tested in the 6 months following the intervention was determined from electronic medical records.
6 months

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Weight intervention participant engagement with the interactive technology-based supports
Prazo: 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.
Prazo: 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
Prazo: 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
Prazo: 3 months
Difference in weights recorded in 6-month and 9-month questionnaires was calculated for all participants in the weight group.
3 months

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Investigadores

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

Publicações e links úteis

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Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo

1 de dezembro de 2011

Conclusão Primária (Real)

1 de março de 2013

Conclusão do estudo (Real)

1 de março de 2013

Datas de inscrição no estudo

Enviado pela primeira vez

13 de agosto de 2013

Enviado pela primeira vez que atendeu aos critérios de CQ

14 de agosto de 2013

Primeira postagem (Estimativa)

15 de agosto de 2013

Atualizações de registro de estudo

Última Atualização Postada (Estimativa)

15 de agosto de 2013

Última atualização enviada que atendeu aos critérios de controle de qualidade

14 de agosto de 2013

Última verificação

1 de agosto de 2013

Mais Informações

Termos relacionados a este estudo

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • NDEP-GDM GS10F0381L
  • GS10F0381L (Número de outro subsídio/financiamento: GSA)

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