JMIR Publications

ABSTRACT

Background:

Given the growing burden of diabetes in underserved communities and the complexity of diabetes self-management during pregnancy, the development of interventions to support low-income pregnant women with diabetes is urgently needed.

Objective:

The objective was to develop and pilot test a theory-driven curriculum of text messaging for diabetes support and education during pregnancy.

Methods:

This was a prospective pilot investigation of a novel text messaging intervention offered to pregnant women with pregestational or gestational diabetes mellitus and publicly-funded prenatal care. Prior work yielded a conceptual model of diabetes self-management barriers and support factors in this population, which was used to guide curriculum development along with health behavior theories. Participants received three one-way text messages per week during pregnancy. Semi-structured, in-depth interviews were performed at study exit to solicit feedback on the program. Narrative data were analyzed using the constant comparative technique to identify themes and subthemes.

Results:

Participants (N=31 enrolled and N=26 completed both interviews) consistently reported the text messaging provided enhanced motivation for diabetes self-care, reduced diabetes-related social isolation, increased perceived diabetes-associated knowledge, enhanced comfort with the health care team, and reduced logistical burdens of diabetes during pregnancy. Participants requested enhanced interactive and customizable features in future intervention iterations.

Conclusions:

Pregnant women with diabetes who were enrolled in a pilot study of a text messaging curriculum for diabetes support described enhanced motivation, knowledge, and comfort with diabetes self-care activities as a result of the health education intervention. Next steps include to enrich the interactive features of the intervention and to investigate the effect of the intervention on perinatal outcomes.