Development of digital health platform to track glucose, diet, and physical activity to prevent gestational diabetes in high-risk South Asian women (DESI-GDM Digital).
The proposed study will develop and pilot test an integrated DHP to deliver diet and exercise advice, and collect diet, exercise, and glucose data, to prevent dysglycemia in high-risk pregnant SA women residing in Peel. In consultation with physicians, dietitians, participants, behavioural psychologists, nurses, and digital health experts, we will:
A. Develop a motivational and reminder text messaging sequence for pregnant SA women that will provide information and bi-directional feedback to support healthy lifestyle choices aimed at preventing the development of GDM.
B. Develop an integrated “one-stop” digital platform (such as a smartphone or computer-accessible app) to allow pregnant women to track blood glucose, activity, and diet by:
- Tracking daily blood glucose readings (linked with Libre Freestyle).
- Tracking daily activity, measured as number of steps taken (linked with FitBit Flex)
- Tracking dietary intake (linked with MyFitnessPal + food photographs)
C. Evaluate the feasibility and acceptability of the individual tools and integrated platform through focus group feedback.
The study will consist of four major phases:
- Developing the personalized messages
- Development of the text messaging system and integrated DHP
- A 2-week trial of the health messaging, tracking apps (Freestyle Libre, Fitbit Flex, MyFitnessPal), and integrated DHP
- Focus groups with participants.
The process outcome measures of the pilot study assess the feasibility of the DHP, defined by:
- Success at transmitting health messages via electronic media (text messaging and e-mail)
- Success at participants wearing the Libre Freestyle (at least 10 days of data), FitBit (at least 10 days of wear) and engaging with MFP (at least 6 days logged), as this reflects the uptake of the intervention and helps to assess the effect of intervention on health behaviors
- Successful development of the integrated platform. If >90% of electronic communications are sent and acknowledged by participants and ≥16 participants, are able to provide at least 10 days’ of glucose data, wear the FitBit for ≥10 days, and track food for ≥6 days (out of 14 days), and the platform successfully integrates the 3 data sources (i.e. simultaneous track of glucose, activity, and diet at a single portal or app), we will consider the digital intervention feasible to use in our trial. Unmet targets will be used by the study team to understand the reasons for the failure, and to develop plans to mitigate in the full scale trial.
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Sonia Anand and Russell de Souza