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一项针对越南北方妊娠期糖尿病女性的共同创建的自我护理与非正式支持干预措施(VALID-II):一项双臂非随机可行性研究方案

A co-created self-care and informal support intervention targeting women with gestational diabetes mellitus in northern Vietnam (VALID-II): a protocol for a two-arm non-randomised feasibility study.

作者信息

Linde Ditte S, Le Hieu M, Vu Dung T K, Dang Ngoc-Anh T, Nguyen Ai T, Vu Tuc P, Nguyen Xuan-Bai, Nguyen Cuong D, Meyrowitsch Dan W, Søndergaard Jens, Vinter Christina A, Bygbjerg Ib C, Rasch Vibeke, Nguyen Thanh D, Gammeltoft Tine M, Nguyen Dang K

机构信息

Research unit for Gynaecology & Obstetrics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.

出版信息

Pilot Feasibility Stud. 2025 May 29;11(1):73. doi: 10.1186/s40814-025-01657-x.

Abstract

BACKGROUND

Gestational diabetes mellitus (GDM) is a transitory form of diabetes that presents during pregnancy with frequent adverse maternal and neonatal health consequences if left untreated. The prevalence of GDM is rapidly increasing in low- and middle-income countries such as Vietnam, and early sustainable interventions are important. The overall aim of this study-henceforth referred to as VALID-II-is to assess the feasibility of a co-created self-care and informal support intervention targeted at pregnant women with GDM. Further, the aim is to assess the potential efficacy of the intervention in reducing maternal and neonatal health complications compared with standard care.

METHODS

VALID-II is a two-site, two-arm, non-randomised feasibility intervention study in Thai Binh Province in northern Vietnam with a delayed start for the intervention group. The intervention study is nested in a larger cohort. In total, 2000 pregnant women will be screened for GDM, with an estimated 400 women screening positive according to the World Health Organisation-International Association of Diabetes and Pregnancy Study Group diagnostic criteria. First, 200 women who screen positive for GDM will be assigned to a control group that will receive standard care. Among the 200 women, 20 will take part in an in-depth ethnographic study along with their family members, and the intervention will be co-created with them. Second, once the intervention has been created, 200 women will be assigned to the intervention group, which will receive the intervention plus standard care. Twenty women and their families from the intervention group will also take part in an ethnographic study. The primary outcome is to evaluate how feasible the self-care intervention is (composite outcome: recruitment, retention, and acceptability). Other secondary outcomes include the number of new-borns born large for gestational age, prevalence and risk factors for GDM, self-care agency, self-care, and breastfeeding practices.

DISCUSSION

This study provides knowledge of the feasibility of informal/self-care and social support interventions and their preliminary impact on maternal and child health outcomes among women with GDM in northern Vietnam. Furthermore, it will inform parameters such as effect size and variance, which are essential for calculating the sample size needed to achieve the desired power in a future full-scale trial. This may guide decision makers in how to optimise the management of GDM in low- and middle-income contexts.

TRIAL REGISTRATION

NCT05744856.

TRIAL STATUS

Recruiting.

摘要

背景

妊娠期糖尿病(GDM)是一种在孕期出现的暂时性糖尿病形式,如果不进行治疗,往往会给母婴健康带来诸多不良后果。在越南等低收入和中等收入国家,GDM的患病率正在迅速上升,因此早期的可持续干预措施至关重要。本研究(以下简称VALID-II)的总体目标是评估一种针对GDM孕妇共同创建的自我护理和非正式支持干预措施的可行性。此外,该研究旨在评估与标准护理相比,该干预措施在降低母婴健康并发症方面的潜在效果。

方法

VALID-II是一项在越南北部太平省进行的双地点、双臂、非随机可行性干预研究,干预组延迟启动。该干预研究嵌套在一个更大的队列中。总共将对2000名孕妇进行GDM筛查,根据世界卫生组织 - 国际糖尿病与妊娠研究组诊断标准,预计有400名妇女筛查呈阳性。首先,200名GDM筛查呈阳性的妇女将被分配到接受标准护理的对照组。在这200名妇女中,20名将与其家庭成员一起参与一项深入的人种学研究,并与她们共同创建干预措施。其次,一旦创建了干预措施,另外200名妇女将被分配到干预组,该组将接受干预措施加标准护理。干预组的20名妇女及其家人也将参与一项人种学研究。主要结局是评估自我护理干预措施的可行性(综合结局:招募、留存率和可接受性)。其他次要结局包括大于胎龄儿的新生儿数量、GDM的患病率和危险因素、自我护理能力、自我护理情况以及母乳喂养习惯。

讨论

本研究提供了关于非正式/自我护理和社会支持干预措施的可行性及其对越南北部GDM妇女母婴健康结局的初步影响的知识。此外,它将为效应量和方差等参数提供信息,这些参数对于计算未来大规模试验中达到所需效能所需的样本量至关重要。这可能会指导决策者如何在低收入和中等收入背景下优化GDM的管理。

试验注册

NCT05744856。

试验状态

招募中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a03/12121233/753d23cf0109/40814_2025_1657_Fig1_HTML.jpg

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