Tu Puedes—An Exploratory Usability Pilot of a Postpartum Education "App" for Latina Women with Previous Gestational Diabetes Free

Gestational diabetes mellitus (GDM) affects nearly 14% of Latina women—a rate significantly higher than the background population. Standard-of-care dictates that postpartum education should be provided though it is rarely done due to socioeconomic, linguistic, transportation and childcare barriers. We propose that a smartphone application (app) has the potential to serve as a cost-effective approach to delivering health education that can break through these barriers and empower postpartum Latina women with the education requisite for making positive lifestyle changes. We designed a small pilot study to test the app’s usability to inform larger studies. Tu Puedes is a culturally and linguistically appropriate diabetes prevention app we developed in Spanish. Women with previous GDM aged 18-40 years completed 4 lessons, either though the app or via an in-person classroom setting with a scripted curriculum. A pre- and post-survey was given to assess participants’ qualitative experience using the app. In addition, standard metabolic measures at baseline and post-intervention (4 weeks) were completed, and compared for both groups. Of the 22 women recruited, 17 completed all 4 lessons, with greater retention in the app group. Survey responses were overall positive, with 73% of participants deeming the app both easy to use and better than any past group education. Users had a 40% increase in self-perceived health, 67% of users wanted to continue use of the app, and all users would recommend it to a friend. Though insufficiently powered and for nominal duration, we found significant decreases in weight and BMI compared to the control group with 90% and 95% confidence respectively, but not in blood pressure or waist circumference. Our results suggest that the Tu Puedes app is a feasible and user-friendly way to disseminate postpartum diabetes prevention education to a Spanish-speaking Latina population with previous GDM, and support the need for further research.