Mobile Health App to Reduce Diabetes in Latina Women with Prior Gestational Diabetes - Abstract
Despite Latinos being the largest ethnic minority, with almost 56.5 million latinos living in the US, they
are one of the most medically underserved groups. Latina women have one of the highest rates of gestational
diabetes mellitus (GDM) in the U.S. Moreover, GDM is a major risk factor for type 2 diabetes (T2DM), with up
to 60% of women developing T2DM within 10 years of a GDM pregnancy. Given the growing obesity epidemic,
rates of GDM and T2DM are likely to increase in the absence of preventive interventions. Addressing the risk
of T2DM after GDM is critical to reducing health disparities faced by Latina women.
The postpartum period is widely-recognized as representing a “window of opportunity” to improve the
future health of women who have had complicated pregnancies, including GDM. However, delivery of
preventive interventions is challenging due to systems-related factors, including lack of time and resources for
providers to provide lifestyle modification counseling, as well as patient challenges, including multiple demands
of the postpartum period leaving little time for women to engage in preventive activities. Technology can help
overcome these barriers, as demonstrated by the success of our web-based CDC-funded Balance after Baby
(BAB) intervention, which successfully promoted weight loss in women with recent GDM. Qualitative results
from BAB, which revealed that women strongly wanted the program delivered via an app, led us, in partnership
with Latina women with recent GDM, to develop a Phase I m-health intervention program for Latina women,
called ¡Hola Bebé, Adiós Diabetes!, in which we tested the preliminary effectiveness of a mobile app in
reducing risk factors for the development of T2DM in Latina women who had GDM in the prior 5 years. The
proposed Phase II application builds on the promising Phase I results which showed acceptability of the
program, increased self-efficacy for healthy lifestyle and weight loss in Latina women with recent GDM. Phase
II Specific Aims are as follows: Aim 1: Enhance Hola Bebé to include: a) an IOS version b) integrated
databases and data analytics to enable population health management and reporting c) expanded content
based on Phase I participant recommendations. Aim 2: Evaluate the effectiveness of Hola Bebé in RCT with
Latina women with recent GDM. We hypothesize that participants receiving Hola Bebé will show: increased
self-efficacy for healthy eating and physical activity (Primary Outcomes), greater weight loss (Secondary
Outcomes), and a greater decrease in HbA1C levels (Exploratory hypothesis) compared to controls.
Successful achievement of study aims will result in a culturally tailored, user-centered, low-cost, high-
reach, and easy to use evidence-based m-health intervention to reduce risk factors for T2DM in Latina women
with a recent history of GDM. The intervention can help reduce the stark ethnic disparities in T2DM among the
Latino population while providing a model for an m-health solution that addresses the many systems-based,
time, and cost barriers to preventive care typically seen in community-based settings.
