NCT01923350

Brief Summary

The Avoiding Diabetes After Pregnancy Trial (ADAPT) study was designed to test the effectiveness of interventions that potentially increase the adoption of Diabetes Prevention Program (DPP) elements by women who had a pregnancy with gestational diabetes mellitus (GDM). The study was conducted as an integrated trial with two separate arms: one to facilitate weight reduction and the other to increase diabetes testing. There were two hypotheses:

  • To evaluate the impact of the weight reduction intervention in terms of participant engagement with the interactive technology-based supports.
  • To evaluate changes in the women's perception of their personal diabetes risk following after exposure to information about diabetes risk following a pregnancy with GDM.
  • To identify the determinants and motivators of and barriers to diabetes testing in the 6- to 12-week postpartum period and thereafter, using the Health Belief model to guide the study. There was an additional secondary aim involving metformin:
  • To evaluate the impact of the diabetes risk reduction intervention in terms of women seeking out their physician's advice on metformin treatment and receiving a metformin prescription, if appropriate.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
140

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Dec 2011

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

December 1, 2011

Completed
1.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2013

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2013

Completed
6 months until next milestone

First Submitted

Initial submission to the registry

August 13, 2013

Completed
2 days until next milestone

First Posted

Study publicly available on registry

August 15, 2013

Completed
Last Updated

August 15, 2013

Status Verified

August 1, 2013

Enrollment Period

1.2 years

First QC Date

August 13, 2013

Last Update Submit

August 14, 2013

Conditions

Keywords

Weight reductionBehavioral interventionGestational diabetes mellitusType 2 diabetesDiabetes testing

Outcome Measures

Primary Outcomes (2)

  • For participants in weight group, weight reduction from baseline to 6 months

    Participants reported their weights online at baseline, 3 months, 6 months, and 9 months, and the difference in weight from baseline to 6 months was the primary measure of the intervention's success.

    6 months

  • In testing group, the number of women receiving a diabetes test per ADA Guidelines in the 6-month post-intervention period

    The number of women who were tested in the 6 months following the intervention was determined from electronic medical records.

    6 months

Secondary Outcomes (4)

  • Weight intervention participant engagement with the interactive technology-based supports

    9 months

  • Success of participants in weight intervention arm in achieving behavior change goals.

    9 months

  • Weight change from baseline to 9 months

    9 months

  • Weight change from 6 to 9 months

    3 months

Study Arms (4)

Weight Reduction Intervention

EXPERIMENTAL
Behavioral: Weight Reduction Intervention

Weight Reduction Control Arm

ACTIVE COMPARATOR
Behavioral: Weight Reduction Control Arm

Tested for diabetes

ACTIVE COMPARATOR
Behavioral: Tested for diabetes

Not tested for diabetes

ACTIVE COMPARATOR
Behavioral: Not tested for diabetes

Interventions

The weight trial intervention components were: * Electronic feedback from the ADAPT interactive obesity treatment approach (iOTA) system, tracking participants' behavior change goals. Participants received feedback either by daily SMS (text messaging) or by weekly IVR (interactive automated calls). * Seven behavior change coaching calls, once a month for 6 months, and then one at 7.5 months halfway through the maintenance period. * Print mailings/emailings * 3 Get Ready e-messages in the four weeks before the weight intervention began * Pedometers and program guides. (IVR users received printed activity logs with their program guides.) * Access to the ADAPT iOTA website for reviewing their progress and obtaining information on behavior change goals.

Weight Reduction Intervention

Participants received an initial brochure about managing diabetes risk, a digital scale to use in entering their weights in online questionnaires, and monthly emailed wellness messages unrelated to diabetes.

Weight Reduction Control Arm

Due to small numbers in this group, the planned intervention was changed to a mixed-mode study, using baseline and follow-up self-administered questionnaires and semi-structured questionnaires administered to a sub-sample of those tested for diabetes to identify factors differentiating the behavior of women who had and had not been tested for diabetes following a pregnancy with gestational diabetes mellitus.

Tested for diabetes

Due to small numbers in this group, the planned intervention was changed to a mixed-mode study, using baseline and follow-up self-administered questionnaires and semi-structured questionnaires administered to a subsample of those not tested for diabetes to identify factors differentiating the behavior of women who had and had not been tested for diabetes following a pregnancy with gestational diabetes mellitus.

Not tested for diabetes

Eligibility Criteria

Age18 Years+
Sexfemale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • General
  • History of GDM in the previous 6 months to 4.5 years
  • Access to the internet and text messages or phone messages
  • Current patient of Harvard Vanguard Medical Associates
  • years of age or older
  • Able to read in English
  • Weight Reduction Group
  • Overweight or obese
  • Capable of performing moderate physical activity
  • Diabetes Testing Group
  • Had not competed a diabetes test (OGTT or fasting blood sugar at 6-12 weeks postpartum or OGTT, fasting blood sugar or hemoglobin A1c after 12 weeks postpartum)

You may not qualify if:

  • General:
  • Diabetes diagnosis
  • Psychotic disorder diagnosis
  • Enrolled in a research study
  • Weight Reduction Group
  • Taking prescription medications for weight loss
  • Engaged in a formal weight reduction program
  • Diabetes Testing Group
  • History of postpartum OGTT, fasting plasma glucose or hemoglobin A1c (after 6 weeks postpartum)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Social & Scientific Systems Inc.

Silver Spring, Maryland, 20910, United States

Location

Related Publications (1)

  • Paez KA, Griffey SJ, Thompson J, Gillman MW. Validation of self-reported weights and heights in the avoiding diabetes after pregnancy trial (ADAPT). BMC Med Res Methodol. 2014 May 13;14:65. doi: 10.1186/1471-2288-14-65.

MeSH Terms

Conditions

Weight LossDiabetes, GestationalDiabetes Mellitus, Type 2

Condition Hierarchy (Ancestors)

Body Weight ChangesBody WeightSigns and SymptomsPathological Conditions, Signs and SymptomsPregnancy ComplicationsFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesDiabetes MellitusGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System Diseases

Study Officials

  • Susan J Griffey, DPh, BSN

    Social & Scientific Systems Inc.

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 13, 2013

First Posted

August 15, 2013

Study Start

December 1, 2011

Primary Completion

March 1, 2013

Study Completion

March 1, 2013

Last Updated

August 15, 2013

Record last verified: 2013-08

Locations