A Randomized Study of Values Affirmation to Promote Interest in Diabetes Prevention Among Women With a History of Gestational Diabetes

Abstract

Objective: To test whether two interventions promote interest in diabetes prevention among women with a history of gestational diabetes mellitus (GDM), who face high lifetime risk for diabetes. Research Design and Methods:We designed an email outreach message promoting an existing preventive lifestyle program. The message incorporated values affirmation, a theory-based intervention that can improve openness to health information but typically relies on a writing exercise less practical in healthcare settings. In a 3-arm randomized study, 237 women with elevated BMI and a history of GDM were randomized to read an outreach message containing either no affirmation (control) or one of two affirmations, streamlined to remove the typical writing exercise: either a values affirmation prompting reflection on any personal value, or a parenting affirmation prompting reflection on caregiving-related values. Outcomes included demonstrating interest in the lifestyle program (seeking information about it or intending to join) and seeking publicly-available health information about diabetes prevention.Results: Compared to control, participants randomized to the values affirmation more frequently demonstrated interest in the lifestyle program (59.0% vs. 74.4%; adjusted relative risk [95% CI]: 1.31 [1.04-1.66]) and sought information about diabetes prevention (59.0% vs. 73.4%; 1.22 [0.97-1.54]). The parenting affirmation yielded no significant differences in either outcome. Conclusions:A streamlined values affirmation, designed for feasibility in a healthcare setting, can promote interest in diabetes prevention among women at high-risk. Research is needed to evaluate its effects on diabetes prevention program enrollment and clinical outcomes.

Reach, acceptability, and perceived success of a telehealth diabetes prevention program among racially and ethnically diverse patients with gestational diabetes: the GEM cluster-randomized trial

“…For patients with GDM, barriers to participation in postpartum diabetes prevention include time constraints, fatigue, and other demands of parenthood [13]. Yet recent research indicates strong interest in behavioral intervention for diabetes prevention [14], which can be further strengthened via theory-driven strategies [15]. In fact, a history of GDM has been linked with greater engagement in diabetes prevention activities [16].…”

Effect of Values Affirmation on Reducing Racial Differences in Adherence to Hypertension Medication

“…Values affirmation is inexpensive, occurs outside of the patient-clinician interaction, and has the potential to be scaled for dissemination. 40 , 41 , 42 Values affirmation targets the fear of negative stereotyping and is not specific to a disease or stereotyped group. Therefore, a scalable, pragmatic means to deliver values affirmation has the potential to improve patient-clinician communication and patient activation across a wide range of health care conditions and populations.…”

“…Therefore, our finding of higher patient activation among patients in the intervention group has implications for future work. Values affirmation is inexpensive, occurs outside of the patient-clinician interaction, and has the potential to be scaled for dissemination . Values affirmation targets the fear of negative stereotyping and is not specific to a disease or stereotyped group.…”

A Systematic Review on Prevention of Type 2 Diabetes Mellitus after Gestational Diabetes Mellitus

“…Compared with women without this common complication women with a history of GDM face a 7-fold increased risk for developing diabetes later in life [4]. In addition, the cumulative risk of developing T2DM in women with a history of GDM at 10 years after giving birth varies from 20 to 50% [5].…”