Postpartum women’s experiences in a randomized controlled trial of a web-based lifestyle intervention following Gestational Diabetes: a qualitative study

Abstract

Introduction

Gestational diabetes mellitus (GDM) is associated with an increased maternal risk for the development of type 2 diabetes (T2DM). We previously demonstrated in a randomized trial that a web-based postpartum lifestyle intervention program, Balance After Baby, increased weight loss among postpartum women with recent pregnancies complicated by GDM. The aim of this analysis is to identify the impact of the intervention on study participants as assessed by exit interviews after completion of the 12 month study.

Methods

We conducted structured exit interviews created with a concurrent-contextual design with subjects randomized to the intervention group at the conclusion of their participation (∼12 months) in the Balance After Baby study, with the objectives of 1) understanding the impact of the intervention on participants and their family members, 2) identifying which program components were most and least helpful, and 3) identifying the perceived best timing for diabetes prevention interventions in postpartum women with recent GDM.

Results

Seventy-nine percent (26/33) of eligible intervention participants participated in interviews. Participants noted changes in diet and physical activity as a result of the intervention. Several components of the intervention, particularly the online modules and support from the lifestyle coach, were perceived by intervention participants to have had a positive effect on personal and familial lifestyle change, while other components were less utilized, including the community forum, YMCA memberships, and pedometers. Nearly all participants felt that the timing in the intervention study, beginning about 6 weeks postpartum, was ideal.

Discussion

Results of this study identify the importance of individualized coaching, impact on family members, and demonstrate that postpartum women feel ready to make changes by 6 weeks postpartum. Findings from this study will help inform the development of future technologically-based lifestyle interventions for postpartum women with recent GDM.

Keywords:

• Gestational diabetes
• postpartum
• web-based intervention
• qualitative research

Acknowledgments

The authors thank the women who participated in the Balance After Baby trial.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The Balance after Baby study was supported by the Centers for Disease Control [Cooperative Agreement Number MM-1094–09/09, announcement number CD05-050], and work by the investigators was supported by an Institutional National Research Service Award #T32AT000051 from the National Center for Complementary and Alternative Medicine at the National Institutes of Health, and a K23 [1K23HL133604] and K24 [9K24HL096141] from the National Heart Lung and Blood Institute at the National Institutes of Health. The findings and conclusions are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.