Periodic mobile application (eMOM) with self-tracking of glucose and lifestyle improves treatment of diet-controlled gestational diabetes without human guidance: a randomized controlled trial

Kytö, Mikko; Hotta, Shinji; Niinistö, Sari; Marttinen, Pekka; Korhonen, Tuuli E.; Markussen, Lisa T.; Jacucci, Giulio; Sievänen, Harri; Vähä-Ypyä, Henri; Korhonen, Ilkka; Virtanen, Suvi; Heinonen, Seppo; Koivusalo, Saila B.

doi:10.1016/j.ajog.2024.02.303

Cited by 3 publications

(9 citation statements)

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“…The scale for TSRQ and PCS was from 1 (=low) to 7 (=high eMOM usage eMOM was mostly used in the mornings (0700 -1000) and the evenings (1900 -2200), see Figure 2a. The number of interactions with eMOM has been previously reported [14]. During the first application week, the users interacted with eMOM 18.7 times/day on average (see Figure 2b).…”

Section: Participantsmentioning

confidence: 61%

“…The recent results of our randomized controlled trial (RCT) demonstrated that the women with GDM and using eMOM improved their fasting glucose levels, enhanced physical activity, increased vegetables intake, and resulted in less weight gain during pregnancy [14]. Additionally, the incidence of newborns with macrosomia was lower among the women using eMOM [14]. Many of these improved clinical outcomes correlated with the usage of eMOM, suggesting that eMOM supported self-management of women with GDM.…”

Section: Supporting Self-management In Women With Gestational Diabete...mentioning

confidence: 83%

“…In analyzing correlation between motivation and primary outcome from Kytö, et al [14], we examined the linear relationship (Pearson correlation). For the binary outcomes, we employed logistic regression.…”

Section: Discussionmentioning

confidence: 99%

“…Third, eMOM is used periodically, one week a month, to avoid getting tired of digital device. The recent results of our randomized controlled trial (RCT) demonstrated that the women with GDM and using eMOM improved their fasting glucose levels, enhanced physical activity, increased vegetables intake, and resulted in less weight gain during pregnancy [14]. Additionally, the incidence of newborns with macrosomia was lower among the women using eMOM [14].…”

Section: Supporting Self-management In Women With Gestational Diabete...mentioning

confidence: 92%

“…Correlations between autonomous motivation (TSRQ) and perceived competence (PCS) and improved primary and secondary clinical outcomes [14] in the intervention arm are shown in Table 7. No significant correlations were found in change of motivational factors and improved clinical outcomes.…”

Section: Correlations Between Motivation and Improved Clinical Outcomesmentioning

confidence: 99%

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Supporting Self-Management in Women with Gestational Diabetes: The Effect of eMOM Mobile Application on Self-Discovery and Psychological Factors – A Mixed-Methods Study (Preprint)

Määttänen,

Koivusalo,

Ylinen

et al. 2024

Preprint

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BACKGROUND Gestational diabetes (GDM) is a type of diabetes that develops during pregnancy and predisposes a mother to the later type 2 diabetes. The prevalence of GDM increases, that underscores the need to adopt more comprehensive treatment strategies, especially supporting maternal self-management. We showed recently that a mobile app (eMOM) where glucose, nutrition, and physical activity are combined within a single app improves significantly multiple clinical outcomes among women with gestational diabetes. OBJECTIVE This study aims to explore the effects of the eMOM on maternal self-discovery, learning, autonomous motivation to manage GDM, and psychological well-being. We also examined the correlation between improved maternal clinical outcomes and change in autonomous motivation. METHODS Building upon the original randomized controlled trial (RCT), in which the intervention arm used a mobile app (eMOM), we conducted a mixed-methods study which included semi-structured interviews on self-discovery, examination of eMOM log files, and questionnaires assessing motivation (TSRQ and PCS), technology usage and acceptance (UTAUT), usability (modified SUMI), and depression (EPDS). Additionally, we monitored participants' stress levels using wearable EKG devices (FirstBeat Bodyguard 2). RESULTS A total of 148 women participated in the RCT study, with 76 in the intervention arm and 72 in the control arm. From the intervention arm, 18 participants were randomly selected for interviews. Results show that novel visualization supported self-discovery in women with GDM. The vast majority of participants (94%, 17 out of 18) indicated that the eMOM app helped to find the correlations between their daily activities and glucose levels. Especially having nutrition visualized together with glucose was highly appreciated. Participants also reported learning about the associations between physical activity and glucose levels. However, there weren´t any differences between intervention and control arm in autonomous motivation, depression, or stress. In addition, there were no correlations between improved clinical outcomes and changes in motivation. CONCLUSIONS The mobile application combining data from continuous glucose monitoring, food diary, and physical activity tracker supports maternal self-discovery regarding GDM. This encourages the utilization of such a mobile app into maternity care. CLINICALTRIAL ClinicalTrials.gov NCT04714762

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Section: Participantsmentioning

confidence: 61%

Section: Supporting Self-management In Women With Gestational Diabete...mentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Supporting Self-management In Women With Gestational Diabete...mentioning

confidence: 92%

Section: Correlations Between Motivation and Improved Clinical Outcomesmentioning

confidence: 99%

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