Grant: Op. Gr.:Diabetes, Psychosocial Health, Prev./Self-Manag. - CIHR-JDRF Pool in T1D

Depression and anxiety in people with diabetes is 2 to 4 times greater than in the general population and negatively impacts blood glucose levels, self-management and quality of life. The pregnancy planning and perinatal period (pregnancy and postpartum) is a critical life stage with unique psychosocial challenges for people with pregestational diabetes (PGD) (type 1 or type 2). There are no tailored interventions to promote mental health and the transition to parenthood or women/birthing persons with PGD during this life stage. Digital interventions (DIs) are a far-reaching and effective method of preventing and treating psychological problems in the perinatal period in people without diabetes. We have previously developed and evaluated a bilingual, web-based platform (HealthyMoms) for pregnant and postpartum individuals that provides accurate and easily accessible information on depression, anxiety and stress during the perinatal period and evidence-based strategies to address these factors. We are now proposing to adapt and evaluate an engagement enhanced version that is tailored to the needs of women/birthing persons with PGD to promote diabetes-specific psychosocial and mental health outcomes during the pregnancy planning and perinatal periods. Phase 1 of this study will gather information from persons with PGD to identify new content and features tailored to the PGD context during this life stage. Phase 2 will evaluate if the program is acceptable to persons with PGD and we will obtain initial results on it's usefulness in reducing diabetes distress and general psychological distress by comparing a version that is designed to increase usage with the platform (HealthyMoms DM+ coaching) compared to a self-guided only version (HealthyMoms DM). The proposed project fills an important gap in current healthcare and web-based resources targeting the prevention of maternal psychological difficulties during this life transitions for individuals with PGD.