Text for Success in Gestational Diabetes: Development and User Experience Testing of a Text Messaging Program

Rachel Blair, MD
Department of Medicine
Division of Endocrinology, Diabetes, and Hypertension
Poster Overview

Gestational diabetes is a condition in which women develop high blood sugars during pregnancy and it can cause health problems for both mothers and babies. Text messages are helpful for people who have diabetes in general, but have not been studied for women with gestational diabetes. Our goal was to design a personalized text messaging program in English and Spanish for women with gestational diabetes to check their blood sugars multiple times per day. The program will also give positive feedback and information about leading a healthy lifestyle. Importantly, the text messages can be sent without in-person contact, making them very helpful during the COVID pandemic when in-person interaction between patients and their healthcare teams have been greatly reduced. Ten women with gestational diabetes received simulated text messages and gave us feedback on the wording and content of messages. All women thought the program would be helpful and would use it during their first pregnancy with gestational diabetes. Women particularly liked that the timing of messages could be personalized and really liked messages about healthy lifestyles such as healthy snack ideas and exercise. They suggested increasing the ability to customize timing of text messages and limiting technical medical terms.

Scientific Abstract

Background: Gestational diabetes mellitus (GDM) affects 5-10% of pregnancies and can lead to serious fetal and maternal complications. Text messaging is an effective way to improve diabetes management outside of pregnancy, but has not been studied in GDM. Importantly, text messaging facilitates patient education completely virtually which is crucial during the COVID-19 pandemic.

Methods: Women with GDM received simulated program messages on a study smartphone and participated in semi-structured interviews to provide feedback. The program was developed in English and Spanish and based on the Health Belief Model. It includes: 1) reminders to check blood glucoses, 2) positive feedback to user-reported glucoses, 3) weekly educational messages and 4) weekly motivational messages.

Results: 10 women participated; all thought the program would be helpful and would use it during their first pregnancy with GDM. Participants particularly liked customization of message timing and messages with information about healthy lifestyle. Suggestions for optimization included further customization of message timing and minimization of jargon.

Conclusions: Overall, women with GDM would use the “Text4Success in GDM” program and think it would be helpful for GDM self-management. We are testing the optimized text messaging program as it could be an extremely useful tool during the COVID pandemic.

Clinical Implications
Women with gestational diabetes thought the “Text4Success in GDM” text messaging program would be useful and that they would use the program. We piloting the program further as a promising strategy to help women with gestational diabetes during the COVID pandemic and beyond.
Research Areas
Authors
Rachel A. Blair, MD, Jennifer M. Dias, BA, Christine Horn, MA, Sarah E. Little, MD, MPH, Nawal Nour, MD, MPH, Marie E. McDonnell, MD, Ellen W. Seely, MD
Principal Investigator
Rachel Blair, MD

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