title: The Gestational Diabetes Management System (GooDMomS): development, feasibility and lessons learned from a patient-informed, web-based pregnancy and postpartum lifestyle intervention.
abstract: BACKGROUND
  Gestational diabetes mellitus (GDM) contributes to the epidemic of diabetes and obesity in mothers and their offspring. The primary objective of this pilot study was to: 1) refine the GDM Management System (GooDMomS), a web-based pregnancy and postpartum behavioral intervention and 2) assess the feasibility of the intervention.
  
  
  METHODS
  In phase 1, ten semi-structured interviews were conducted with women experiencing current or recent GDM mellitus GDM to garner pilot data on the web based intervention interface, content, and to solicit recommendations from women about refinements to enhance the GooDMomS intervention site. Interviews were audiotaped, transcribed and independently reviewed to identify major themes with Atlas.ti v7.0. In phase 2, a single-arm feasibility study was conducted and 23 participants were enrolled in the GooDMomS program. Participants received web lessons, self-tracking of weight and glucose, automated feedback and access to a message board for peer support. The primary outcome was feasibility, including recruitment and retention and acceptability. Secondary outcomes included the proportion of women whose gestational weight gain (GWG) was within the Institute of Medicine (IOM) guidelines and who were able to return to their pre-pregnancy weight after delivery.
  
  
  RESULTS
  Comments from semi-structured interviews focused on: 1) usability of the on-line self-monitoring diary and tracking system, 2) access to a safe, reliable social network for peer support and 3) ability of prenatal clinicians to access the on-line diary for clinical management. Overall, 21 (91 %) completed the pregnancy phase. 15/21 (71 %) of participants were within the Institute of Medicine (IOM) guidelines for GWG. Sixteen (70 %) completed the postpartum phase. 7/16 (43 %) and 9/16 (56 %) of participants returned to their pre-pregnancy weight at 6 and 30 weeks postpartum, respectively.
  
  
  CONCLUSIONS
  This study documents the feasibility of the GooDMomS program. The results can have implications for web technology in perinatal care and inform the current care paradigm for women with GDM. Findings are supportive of further research with recruitment of a larger sample of participants and comparison of the outcomes with the intervention and standard care.
  
  
  BACKGROUND
  The study was registered at ClinicalTrials.gov on May 15, 2012 under protocol no. NCT01600534 .
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA. wknichol@med.unc.edu.|Partnerships for Women's Endocrine and Reproductive Health (PoWER), University of North Carolina School of Medicine, Chapel Hill, NC, USA. wknichol@med.unc.edu.|Diabetes and Obesity Core, Center for Women's Health Research, University of North Carolina School of Medicine, Chapel Hill, NC, USA. wknichol@med.unc.edu.|The Diabetes Center, University of North Carolina School of Medicine, Chapel Hill, USA. wknichol@med.unc.edu.|Cecil G. Sheps Center for Health Services Research, University of North Carolina School of Medicine, Chapel Hill, NC, USA. wknichol@med.unc.edu.
authors.forename: Wanda K
authors.initials: WK
authors.lastname: Nicholson
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: A Jenna
authors.initials: AJ
authors.lastname: Beckham
authors.affiliation: Department of Nutrition, University of North Carolina School of Medicine, Chapel Hill, USA.|Program on Obesity Treatment, University of North Carolina Gillings Global School of Public Health, Chapel Hill, NC, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Hatley
authors.affiliation: Department of Nutrition, University of North Carolina School of Medicine, Chapel Hill, USA.|Program on Obesity Treatment, University of North Carolina Gillings Global School of Public Health, Chapel Hill, NC, USA.
authors.forename: Molly
authors.initials: M
authors.lastname: Diamond
authors.affiliation: Partnerships for Women's Endocrine and Reproductive Health (PoWER), University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: La-Shell
authors.initials: LS
authors.lastname: Johnson
authors.affiliation: Cecil G. Sheps Center for Health Services Research, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Sherri L
authors.initials: SL
authors.lastname: Green
authors.affiliation: Department of Nutrition, University of North Carolina School of Medicine, Chapel Hill, USA.|Department of Health Behavior, University of North Carolina Gillings Global School of Public Health, Chapel Hill, USA.|Program on Obesity Treatment, University of North Carolina Gillings Global School of Public Health, Chapel Hill, NC, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Tate
mesh_terms: D006801:Humans; D005260:Female; D011247:Pregnancy; D016640:Diabetes, Gestational / Q000517:prevention & control; D008019:Life Style; D049590:Postpartum Period; D010865:Pilot Projects; D020407:Internet; D015430:Weight Gain; D060756:Social Networking
keywords: Behavioral intervention; Gestational diabetes; Postpartum; Pregnancy; Web-based intervention; mhealth; uhealth