Krutilova Petra, Williams Roxann, Morey Rebecca, Field Carole, Byrth Veronda, Tepe Melissa, McQueen Amy, Herrick Cynthia
Washington University School of Medicine, Metabolism & Lipid Research.
TriStar Centennial Medical Center.
Res Sq. 2023 Jun 2:rs.3.rs-2860961. doi: 10.21203/rs.3.rs-2860961/v1.
The risk of developing type 2 diabetes mellitus (T2DM) is up to 50% among women with gestational diabetes mellitus (GDM). GDM also increases risks for pre-term birth, macrosomia, fetal hypoglycemia, and C-section delivery. Education for expectant mothers with GDM about nutrition, exercise, and the risks of developing T2DM after delivery enhances the probability of postpartum diabetes screening. However, the availability of diabetes education is limited. To bridge this gap, our team developed four training modules on GDM tailored for nurses and community health workers. This pilot study assesses changes in knowledge, self-efficacy for providing diabetes education, attitudes, and intentions to recommend diabetes prevention before and after training completion.
These interactive online modules, each lasting 45-60 minutes and featuring engaging case studies and integrated knowledge assessment questions, were disseminated through various professional organizations to clinical staff providing care for women with GDM. Optional pre- and post-training surveys were conducted to gauge the effectiveness of the modules. Collected data did not follow a normal distribution pattern. We provided an overview of the baseline characteristics of the population, self-efficacy, attitudes, intentions, and GDM knowledge by calculating the median scores and interquartile ranges. We assessed the changes in scores on self-efficacy, attitudes, intentions, and GDM knowledge before and after training using non-parametric Wilcoxon matched-pair signed rank tests.
Eighty-two individuals completed baseline evaluation and 20 individuals accessed all modules and completed post-training assessments. Among those completing the training, improvement was noted in GDM knowledge [56.5% (16.0) v. 78.3% (22.0), p < 0.001], Self-efficacy for providing diabetes education [6.60 (2.73) v. 9.33 (0.87), p < 0.001], attitudes toward the value of tight control [4.07 (0.79) v. 4.43 (0.86), p = 0.003], and intentions to recommend diabetes prevention measures [4.81 (0.63) v. 5.00 (0.00), p = 0.009)].
Completion of our interactive online modules improved knowledge, intention to recommend diabetes prevention methods, self-efficacy to provide diabetes education, and attitudes toward the value of tight control among individuals caring for women with GDM. Enhanced accessibility to such curricula is crucial to improve access to diabetes education.
This study was registered at clinicaltrials.gov, identifier: NCT04474795.
妊娠糖尿病（GDM）女性患2型糖尿病（T2DM）的风险高达50%。GDM还会增加早产、巨大儿、胎儿低血糖和剖宫产的风险。对患有GDM的准妈妈进行营养、运动以及产后患T2DM风险的教育，可提高产后糖尿病筛查的可能性。然而，糖尿病教育的可及性有限。为了弥补这一差距，我们的团队为护士和社区卫生工作者开发了四个针对GDM的培训模块。这项试点研究评估了培训完成前后在知识、提供糖尿病教育的自我效能感、态度以及推荐糖尿病预防措施的意愿方面的变化。
这些互动式在线模块，每个持续45 - 60分钟，包含引人入胜的案例研究和综合知识评估问题，通过各种专业组织分发给为患有GDM的女性提供护理的临床工作人员。进行了可选的培训前和培训后调查，以评估这些模块的有效性。收集的数据不遵循正态分布模式。我们通过计算中位数分数和四分位间距，提供了人群的基线特征、自我效能感、态度、意愿和GDM知识的概述。我们使用非参数Wilcoxon配对符号秩检验评估了培训前后自我效能感、态度、意愿和GDM知识分数的变化。
82人完成了基线评估，20人访问了所有模块并完成了培训后评估。在完成培训者中，GDM知识[56.5%（16.0）对78.3%（22.0），p < 0.001]、提供糖尿病教育的自我效能感[6.60（2.73）对9.33（0.87），p < 0.001]、对严格控制价值的态度[4.07（0.79）对4.43（0.86），p = 0.003]以及推荐糖尿病预防措施的意愿[4.81（0.63）对5.00（0.00），p = 0.009]均有改善。
完成我们的互动式在线模块可提高照顾患有GDM女性的人员在知识、推荐糖尿病预防方法的意愿、提供糖尿病教育的自我效能感以及对严格控制价值的态度方面的水平。提高此类课程的可及性对于改善糖尿病教育的可及性至关重要。
本研究已在clinicaltrials.gov注册，标识符：NCT04474795。
