title: Comparing a telephone- and a group-delivered diabetes prevention program: Characteristics of engaged and non-engaged postpartum mothers with a history of gestational diabetes.
abstract: OBJECTIVE
  To explore the acceptability of a telephone- or a group-delivered diabetes prevention program for women with previous gestational diabetes and to compare the characteristics associated with program engagement.
  
  
  METHODS
  Postpartum women participated in a lifestyle modification program delivered by telephone (n=33) or group format (n=284). Semi-structured interviews on barriers and enablers to program engagement (defined as completing≥80% sessions) were conducted before (Group) and after (Group and Telephone) interventions. The Health Action Process Approach theory was used as the framework for inquiry. Psychological measures were compared between engagement subgroups before and after group-delivered intervention.
  
  
  RESULTS
  In the telephone-delivered program 82% participants met the engagement criteria compared with 38% for the group-delivered program. Engaged participants (Group) had significantly higher risk perception, outcome expectancy, and activity self-efficacy at baseline (P<0.05). There was a greater decrease in body weight (-1.45±3.9 vs -0.26±3.5, P=0.024) and waist circumference (-3.56±5.1 vs -1.24±5.3, P=0.002) for engaged vs non-engaged participants following group program completion.
  
  
  CONCLUSIONS
  Telephone delivery was associated with greater engagement in postpartum women. Engagement was associated with greater reduction in weight and waist circumference. Further studies are required to confirm the effectiveness of telephone-delivered program for diabetes prevention in postpartum women.
authors.affiliation: Faculty of Health, School of Medicine, Deakin Rural Health, Warrnambool, Victoria, Australia; Health Systems Improvement Unit, Centre for Population Health, School of Health and Social Development, Deakin University, VIC, Australia. Electronic address: siew.lim@deakin.edu.au.
authors.forename: Siew
authors.initials: S
authors.lastname: Lim
authors.affiliation: Centre for Population Health Research, Deakin University, VIC, Australia.
authors.forename: James A
authors.initials: JA
authors.lastname: Dunbar
authors.affiliation: Faculty of Health, School of Medicine, Deakin Rural Health, Warrnambool, Victoria, Australia.
authors.forename: Vincent L
authors.initials: VL
authors.lastname: Versace
authors.affiliation: General Internal Medicine Unit, Western Health, Sunshine Hospital, St Albans, VIC, Australia; Department of Medicine, Melbourne Medical School - Western Precinct, University of Melbourne, Sunshine Hospital, St Albans, VIC, Australia.
authors.forename: Edward
authors.initials: E
authors.lastname: Janus
authors.affiliation: Health Systems Improvement Unit, Centre for Population Health, School of Health and Social Development, Deakin University, VIC, Australia.
authors.forename: Carol
authors.initials: C
authors.lastname: Wildey
authors.affiliation: School of Psychological and Clinical Sciences, Charles Darwin University, NT, Australia.
authors.forename: Timothy
authors.initials: T
authors.lastname: Skinner
authors.affiliation: Institute for Physical Activity and Nutrition, Deakin University, VIC, Australia.
authors.forename: Sharleen
authors.initials: S
authors.lastname: O'Reilly
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D016640:Diabetes, Gestational / Q000534:rehabilitation*; D005260:Female; D006126:Group Processes; D006801:Humans; D008019:Life Style; D009035:Mothers; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation / Q000379:methods; D049590:Postpartum Period; D011247:Pregnancy; D012657:Self-Help Groups; D013689:Telephone
keywords: Diabetes prevention; Engagement; Lifestyle intervention; Lifestyle modification; Postpartum women