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

CONTEXT AND OBJECTIVE: To evaluate treatment adherence and satisfaction of a blended mobile health (mHealth) lifestyle intervention among women with prediabetes following gestational diabetes mellitus (GDM). METHODS: Secondary analysis of the mobile-based lifestyle intervention in women with glucose intolerance after a recent history of gestational diabetes 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. RESULTS: Eighty-two participants with complete data at baseline and 1 year postrandomization 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 = .031), smaller waist circumference (80.5 vs 89.7 cm, P = .010), and greater postpartum weight reduction (-3.8 kg vs + 0.95 kg, P = .047). CONCLUSION: 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.