News & Research

    University of Pittsburgh, Pittsburgh, Pennsylvania

Long term effects of receiving preconception counseling in early adolescence

General Research Subject: Type 1 Diabetes

Focus: Diabetes Education, Psychosocial Behavioral Medicine

Type of Grant: Clinical Translational Research

Project Start Date: January 1, 2011

Project End Date: December 31, 2013

Diabetes Type: Type 1 diabetes

Research Description

Uncontrolled diabetes during pregnancy could cause major complications. Preconception Counseling(PC) is an inexpensive  program for reducing these risks. In 2009 the American Diabetes Association(ADA) stated that PC should be started at puberty for all women with diabetes. Since 1999, we've developed and evaluated a PC program for teens with type 1 diabetes (T1D) called Reproductive-health Education and Awareness of Diabetes in Youth for Girls (READY-Girls) to promote awareness of PC and effective family planning. In two separate studies, teens who received READY-Girls improved reproductive health knowledge and attitudes about PC, increased effective family planning, and increased PC discussions with health care providers.  However, the long-term effects of starting PC during adolescence on pregnancy planning behaviors and pregnancy outcomes are not known.

Enough time has lapsed, that we are now in a unique position to recontact all 112 subjects who participated in the two READY-Girls studies and evaluate whether receiving PC (READY-Girls) during early adolescence had a long-term effect on preventing unplanned pregnancies (used effective family planning), pregnancy planning behavior (sought and received preconception counseling and care) and pregnancy outcomes (prevented maternal and neonatal complications). Participants will answer follow-up questions online that will be compared to similar women with diabetes who did not receive READY-Girls. The long-term goal is to empower diabetic women to make informed decisions about their reproductive health, seek PC when they plan a pregnancy and have healthy pregnancy outcomes. To our knowledge, this is the first study that will investigate long-term effects of early PC.

Research Profile

What area of diabetes research does your project cover?  What role will this particular project play in preventing, treating and/or curing diabetes?

During the past decade, I have lead a research team to develop, refine and test the efficacy of the Reproductive-Health Education and Awareness of Diabetes in Youth for Girls (READY-Girls) preconception counseling (PC) intervention for adolescents with type 1 diabetes (T1D) and type 2 diabetes (T2D) in three consecutive randomized control trials (RCT). READY-Girls utilizes information technology to deliver preconception counseling to adolescent girls with diabetes in an effort prevent unplanned pregnancies, empower teens to make informed choices and potentially improve their reproductive health and the health of their future children.

We are now uniquely poised to evaluate the long-term effects of receiving PC (READY-Girls intervention) during early adolescence on preventing unplanned pregnancies (used effective family planning), pregnancy planning behavior (sought and received preconception counseling and care) and pregnancy outcomes (prevented maternal and neonatal complications) in young women with T1D. We have reestablished our research teams to recontact and recruit each of our previous subjects with T1D from our READY-Girls' studies to complete on-line bi-annual follow-up assessments. The present project will look at the long-range effects of READY-Girls on reproductive health behaviors, seeking PC, pregnancy outcomes and preventing complications.

If a person with diabetes were to ask you how your project will help them in the future, how would you respond?

This project will determine long-range outcomes of providing a preconception counseling program initiated during the early teenage years, i.e. the READY-Girls program, in preventing unplanned pregnancies, empowering females to make informed reproductive decisions and improving their reproductive health and the health of their future children.

Why is it important for you, personally, to become involved in diabetes research?  What role will this award play in your research efforts?

As a pediatric diabetes clinical nurse specialist and nurse practitioner, I understand the significance and potential clinical impact of our research on maternal and peri-natal health.  Trained as a behavioral scientist, my focus of research has been to develop and evaluate theory-driven technology-based preconception counseling multi-media interventions to enhance reproductive health decisions and behaviors in young women with diabetes. This award will allow us to determine the long-range effectiveness our READY-Girls program.

In what direction do you see the future of diabetes research going?

I see the future of diabetes research to include translational studies in the community that promote healthy behaviors among individuals with type 1 and type 2 diabetes that empower them to improve their health and quality of life through informed choices and decision support.