Category: Diabetes
Poster Session IV
Given the challenges patients experience establishing diabetes-prevention behaviors after a pregnancy complicated by gestational diabetes (GDM), we developed a GDM-focused postpartum patient navigation intervention to improve factors supporting health after GDM, such as screening, primary care transition, and adoption of healthy lifestyle behaviors. This analysis evaluates the implementation of this program within a randomized controlled trial (RCT) designed to assess feasibility of the intervention.
Study Design:
This is a mixed-methods analysis of feasibility and acceptability data from the SWEET (Sustaining Women’s Engagement and Enabling Transitions after GDM) trial, a RCT of pregnant individuals with GDM randomized to receive intensive patient navigation services versus usual care for one-year postpartum. Feasibility was evaluated via recruitment and retention metrics. Acceptability was evaluated through patient satisfaction with navigator [PSN] surveys (interpersonal [I] and logistical [L] components) and through interviews with participants who were randomized to navigation.
Results:
Forty individuals were enrolled in SWEET. Of 21 participants randomized to navigation, 20 provided data at 4-12 weeks and 18 provided data at 11-13 months postpartum. Over half of those who were eligible and approached enrolled in the RCT (52%); 93% of participants were retained in the RCT to 11-13 months. PSN-L (median 45 of 45, IQR 0) and PSN-I (median 3 of 3, IQR 0) scores were high, demonstrating positive relationships with navigators (Fig). Interviews yielded a comprehensive picture of services that patients reported were performed successfully by navigators as well as areas for programmatic improvement (Table).
Conclusion:
These data demonstrate that a postpartum diabetes prevention-focused patient navigation intervention was feasible and acceptable to individuals who had GDM. Given these early-phase findings, next steps include refining SWEET for a large-scale trial to determine whether this intervention improves cardiometabolic outcomes by promoting access, engagement, self-efficacy, and knowledge.
Lynn M. Yee, MD,MPH (she/her/hers)
Associate Professor
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Julia D. DiTosto, BS, MS (she/her/hers)
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Joe M. Feinglass, PhD
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Charlotte M. Niznik, RN
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Laura Diaz, BS
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Viridiana Carmona-Barrera, N/A
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Brittney R. Williams, MPH
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Brigid Dolan, MD
Associate Professor
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Maria V. Gomez-Roas, BS (she/her/hers)
Medical Student
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
William A. Grobman, MD, MBA
Vice Chair, Clinical Operations, Maternal Fetal Medicine
The Ohio State University
Columbus, Ohio, United States