Treatment adherence and satisfaction of a mobile-based lifestyle intervention in women with prior gestational diabetes.

Abstract

To evaluate treatment adherence and satisfaction of a blended mobile health (mHealth) lifestyle intervention among women with prediabetes following gestational diabetes mellitus (GDM). Secondary analysis of the MELINDA trial evaluating a mHealth lifestyle intervention in women with postpartum prediabetes after GDM. Treatment satisfaction was assessed with the self-designed Treatment Satisfaction Questionnaire. High treatment adherence was defined as app use ≥1 in 5 days and ≥80% attendance at monthly telephonic coaching sessions. Eighty-two participants with complete data at baseline and one year post-randomization were included. The most frequently used app components were the step tracker (61.5%), dietary tips (59.5%), and recipes (34.9%). Telephone coaching was valued by 75.6% of participants, and 84.1% found the app easy to use. High treatment adherence was achieved by 54.9%, and high treatment satisfaction by 41.5% of the participants. Participants with both high treatment adherence and high treatment satisfaction showed the most favorable metabolic outcomes, including lower BMI (23.7 vs. 27.7 kg/m², p=0.031), smaller waist circumference (80.5 vs. 89.7 cm, p=0.010), and greater postpartum weight reduction (-3.8 kg vs. +0.95 kg, p=0.047). The blended mHealth intervention was feasible and generally well-accepted. Women with both high treatment adherence and high treatment satisfaction showed the most favorable metabolic outcomes.