Community Health Worker-Led Postpartum Diabetes Screening
NCT06209411
Summary
Women who experience gestational diabetes are at high risk of developing type 2 diabetes mellitus in the postpartum period-especially in low- and middle-income countries like India where the burden of diabetes is high and disproportionately affects women- but few receive the World Health Organization-recommended postpartum diabetes screening test. The investigators propose a cluster randomized clinical trial to determine whether community health worker-administered, home-based testing increases uptake of postpartum diabetes screening in the urban slums of Pune, India. The proposed study will provide an acceptable and scalable model that can be used to improve postpartum diabetes screening in other low-income settings, thereby improving early detection of diabetes in women and preventing morbidity and mortality in this high-risk population.
Eligibility
Inclusion Criteria: Pregnant Women: * Pregnant woman residing in one of pre-selected slum communities * 18 years or older * ≥ 24 weeks gestational age (as determined by self-reported last menstrual period or ultrasound) * Meet or exceed the threshold for GDM as determined by the CHW-delivered fasting OGTT * Agrees to study procedures, including in-person visits with the CHW postpartum if they are diagnosed with GDM Community Health Workers: * 18 years or older * Willingness to participate in study procedures and recruit eligible pregnant women * Agreement with goals of the study * Resides in one of the study communities * Willing to participate in surveys and interviews Clinicians: * 18 years or older * Diabetes or obstetrics physicians * In a patient-facing position for over 1 year Ministry of Health Officials * 18 years or older * Employed by the Ministry of Health and Family Welfare, Maternal Health Division Exclusion Criteria: Pregnant Women: * Preexisting diabetes diagnosis prior to current pregnancy * Unable to tolerate food/ drink and remain fasting for 8 hoursUnwilling or unable to participate in study procedures * Unwilling or unable to provide informed consent CHW, Clinicians, Ministry of Health Officials 1. Unwilling or unable to participate in study procedures 2. Unwilling or unable to provide informed consent
Conditions3
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NCT06209411