879-P: Using Telehealth to Enhance Engagement and Reduce Patient Burden in the Management of Gestational Diabetes: A Randomized Trial in a Diverse Community Setting

Optimal management of gestational diabetes (GDM) is critical to ensure successful maternal and fetal birth outcomes, yet various factors limit uptake of GDM management education interventions. We developed a psychoeducational intervention for GDM management using a video telehealth platform (TH) as an alternative to routine in-person (RC) sessions to improve patient access and engagement. Both groups were guided by the same providers and received similar educational materials. However, all RC visits were held in-person while all TC visits (except for pre and post assessment) were held virtually. Clinical and psychosocial indicators including out of range blood glucose (BG), birth outcomes, BG monitoring behavior, and patient satisfaction were assessed. Between group comparisons were performed using independent samples t-tests and Fisher’s exact test. Sixty ethnically diverse women with GDM were randomized to TH (n=30) or to RC (n=30). At post assessment, GDM knowledge improved significantly and similarly in both groups (p=0.009), but no group differences were observed on the clinical (including out of range BGs) and psychosocial variables assessed. In late pregnancy, BG monitoring was significantly better in TH (84%) vs. RC (68.4%) (p<0.05). Similarly, attendance at all intervention visits was higher in TH (63.3%) vs. RC (36.7%). Total interaction time for participants completing all intervention visits was significantly shorter in TC (202 min) than in RC (255 min, p<0.001). Although, satisfaction was high in both groups, all but one participant indicated preference for TH for future GDM education. The impact of TH was found to be equivalent to RC on various clinical and psychosocial indicators, but superior in terms of patient engagement, BG monitoring adherence, and patient burden.