(P10-093-24) Effect of a Mobile Health Intervention on Self-Monitoring and Management of Glucose and Blood Pressure Among Women With Gestational Diabetes

Sunday, June 30, 2024

11:45 AM – 12:45 PM CT

Location: Poster Board 587

Presenting Author(s)

AS

Aarthi Shanmugavel, BDS, MPH

Doctorate Candidate
Rutgers University
Franklin Park, New Jersey, United States

Co-Author(s)

AS

Abha Shrestha, MD

Department of Obstetrics and Gynecology, Dhulikhel Hospital-Kathmandu University Hospital, Nepal
JD

Jean-francois Daneault, PhD

Assistant Professor
School of Health Professions, Rutgers University
Newark, New Jersey, United States
PS

Prabin Shakya

Dhulikhel Hospital, Kathmandu University Hospital, Nepal
JN

Jyoti Nepal

Dhulikhel Hospital, Kathmandu University Hospital, Nepal
KC

Kalpana Chaudhary

Institute for Implementation Science and Health, Nepal
AS

Archana Shrestha, PhD

Associate Professor
Department of Public Health, Kathmandu University School of Medical Sciences, Nepal, Institute for Implementation Science and Health, Nepal, Department of Chronic Disease Epidemiology, Yale School of Public Health
Dhulikhel, Bagmati, Nepal
Shristi Rawal, PhD (she/her/hers)

Assistant Professor
Rutgers University
Philadelphia, Pennsylvania, United States

Disclosure(s):

Aarthi Shanmugavel, BDS, MPH: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: Taking a user-centric design approach, we developed a culturally tailored, theory-based mobile application (GDM-DH) for self-management and treatment of women with gestational diabetes (GDM) in a community-based university hospital in Nepal. In a pilot feasibility study among women with GDM, we evaluated the impact of our mobile app intervention on i) compliance with self-monitoring of glucose and blood pressure (BP) levels, and ii) proportion of glucose and BP readings with elevated values (above clinical target ranges), from recruitment to delivery.

Methods: We recruited 95 women newly diagnosed with GDM from Dhulikhel Hospital in Dhulikhel, Nepal, and randomized them to either GDM-DH app + standard care, or standard care alone, from 27±3 gestational weeks to delivery. The intervention group (n=45) were asked to measure their glucose (fasting and postprandial), weight, and blood pressure (systolic, diastolic) readings once a week at home and log them directly onto the mobile app. The control group was instructed to follow the same measurement schedule and record the readings on a paper log which was later entered into a database by a study nurse. Self-monitoring compliance was calculated as the actual number of entries divided by the expected number of entries, multiplied by 100.

Results: Compared to the control group, the intervention group showed higher level of compliance to self-monitoring of glucose (93.9 ± 69.48% vs. 50.8 ± 22.1%, p < 0.001) and BP (81.0 ± 99.3% vs. 26.0 ± 17.6%, p < 0.001). The control group had higher proportion of elevated fasting glucose (readings >95 mg/dl) than the intervention group (59.6% vs. 47.4%, p=0.002). Similarly, the proportion of elevated postprandial glucose levels ( >140 mg/dl) was higher in the control group compared to the intervention group (30.5% vs. 22.3%, p=0.012). There were no significant differences in the proportion of elevated systolic or diastolic BP readings between the intervention and the control group.

Conclusions: Mobile health applications that prioritize user centric approach and incorporate behavioral change theoretical frameworks has the potential to increase compliance with self-monitoring of glucose and BP, as well as decrease the proportion of off-target values, among women with GDM.

Funding Sources: NIH/FIC