Introduction and Objective: Women with a history of gestational diabetes mellitus (GDM) face a high risk of type 2 diabetes, making lifestyle change for prevention essential. Cost and accessibility are barriers to lifestyle change programs. This study evaluated the relationship between patient activation and engagement with diabetes prevention strategies in women with a history of GDM.Methods: Women with a history of GDM were offered free participation in one of seven evidence-based lifestyle change programs. Programs varied in delivery mode, duration, time of day, and childcare availability. Demographic data, BMI, HbA1c, and patient activation (PAM survey) scores were collected at baseline and 12 months. Study completion was defined as attending study visits through the 12-month visit. Non-parametric tests assessed correlations between PAM scores, study completion and changes in BMI and HbA1c.Results: Ninety-two women enrolled, with a median age of 35 years and median BMI of 32.6 kg/m². Most were White (55.4%) and had high patient activation levels (80.4%) at baseline. By 12 months, the dropout rate was 26.1%. Study discontinuation did not vary by baseline PAM score (p=0.290). Among completers, 76.1% retained high activation levels. Median changes in BMI (0%; IQR: -3.1 to 4.0) and HbA1c (1.9%; IQR: -1.9 to 4.7) were not associated with baseline activation level (BMI p=0.707; HbA1c p=0.601).Conclusion: Women with history of GDM may have high activation levels for diabetes prevention. However, support for continued lifestyle change is needed, as patient activation scores alone are not sufficient for predicting program engagement. Future interventions may require additional strategies, such as targeted incentives or enhanced support, to sustain participation in lifestyle programs.
N. El Yaman: None. J.M. Pike: None. K. Haberlin-Pittz: None. L.A. Machuca: None. B.M. McKinney: None. T.S. Hannon: Research Support; Eli Lilly and Company, Novo Nordisk.
Indiana University Precision Health Initiative
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