A digital, co-designed and multilingual intervention to prevent gestational diabetes (Di-Prev): a randomised controlled trial

Research problem and specific questions: Gestational diabetes (GDM) is increasing in Sweden and globally.

GDM increases the risk of adverse pregnancy outcomes as well as later type 2 diabetes and cardiovascular disease for mother and child. Alarmingly, the prevalence is higher among foreign-born women. Preventive and scalable tools are lacking.

This project investigates whether a digital, co-designed and scalable lifestyle intervention available in Swedish, English, Somali and Arabic can prevent GDM during pregnancy in high-risk women.Data and method: The project consists of two work packages (Work Packages, WPs), where we in WP1 will co-create the digital intervention with both the target group and healthcare personnel (qualitative methodology).

In WP2, the effectiveness and scalability of the intervention are evaluated in a randomized controlled trial versus standard care (1:1).

Pregnant women with at least one risk factor for GDM (n=430) will be recruited via maternity care in Region Östergötland.

Outcomes include diagnosed GDM during pregnancy (primary outcome), as well as dietary habits, physical activity, and weight gain at gestational weeks 24-25 and 37-38 (secondary outcomes), and an evaluation of health economic and implementation aspects.Societal relevance and utilisation:  This is the first study to explore whether a digital and scalable lifestyle intervention adapted to multiple languages ​​can prevent the onset of GDM in high-risk women.

It will address key research gaps identified in a recent international report on precision prevention for GDM. If effective, the intervention has great potential to be implemented in Swedish maternal health care.

The possibility to offer such a tool in early pregnancy has potential to improve health in women and their children as well as save resources for the health care system in the short- and long-term perspective.

A particular strength is that the intervention, based on our previous research, can be adapted and tailored to different languages and thus contribute to a more equal maternity health care.Plan for project realisation: The project is led by the main applicant with 15-years of experience in digital health with special emphasis on maternity and child health care.

It is carried out through a unique collaboration with researchers in qualitative methodology, machine learning, endocrinology and implementation and in close collaboration with maternal health care, national and international researchers.