Effectiveness of a Self-Management Program through LINE Application in Pregnant Women with Gestational Diabetes Mellitus, Class A1

Abstract

Introduction Gestational diabetes mellitus is a common complication of pregnancy. Appropriate glycemic control can significantly reduce the risk of complications in both the mother and the infant. The implementation of a self-management program via the LINE application facilitates convenient monitoring of health behaviors and blood glucose levels among pregnant women. Moreover, it enables continuous communication with healthcare teams, thereby promoting effective and sustainable self-care. 

Objective This study aimed to examine the effects of a self-management program delivered via the LINE application on food consumption behaviors, exercise behaviors, and two-hour postprandial blood glucose levels among pregnant women diagnosed with gestational diabetes mellitus, class A1. 

Design This study employed a quasi-experimental with two-group pretest-posttest design to investigate the effects of a self-management program delivered via the LINE application on health behaviors among pregnant women diagnosed with gestational diabetes mellitus, class A1. The program was developed based on Creer’s self-management framework and comprised six key components: 1) Goal Selection: Pregnant women collaborated with healthcare professionals to establish goals for glycemic control and behavioral modification; 2) Information Collection: Participants recorded health-related behaviors, such as dietary intake, exercise, and blood glucose levels, using online forms within the LINE application; 3) Information Processing and Evaluation: This component facilitated awareness of the impact of behaviors on blood glucose levels; 4) Decision-Making: Participants were guided to select appropriate behavioral modification, such as increasing exercise or reducing intake of high-glycemic foods; 5) Action: Pregnant women implemented their individualized plans with ongoing support and feedback from the healthcare team via the LINE application; and 6) Self-Reaction: Participants evaluated their own practices and made necessary adjustments to improve future health behaviors.

Methodology The study sample consisted of 52 pregnant women diagnosed with gestational diabetes mellitus, class A1, recruited between March and July 2024. Participants were purposively selected from an antenatal clinic at a hospital located in northeastern Thailand and were assigned to either the control group (n = 26) or the experimental group (n = 26). The control group received standard care, while the experimental group received standard care and a self-management program delivered via the LINE application over a period of seven weeks. The program was validated for content by five experts, yielding a content validity index of 1.00. Data were collected using a personal information questionnaire, a food consumption behavior questionnaire with reliability revealing Cronbach’s alpha coefficient of .71, an exercise behavior questionnaire reporting Cronbach’s alpha coefficient of .95, and a two-hour postprandial blood glucose recording form. Data were collected in weeks 1, 3, 5, and 7. Data analysis included descriptive statistics, Independent t-test, Paired t-test, and Chi-square test.

Results The experimental and control groups had mean ages of 29.26 years (SD = 5.95) and 28.57 years (SD = 6.16), respectively. There were no statistically significant differences in demographic characteristics. After participating in the program, the experimental group had a significantly higher mean score for food consumption behaviors (M = 41.92, SD = 3.68) compared to before the program (M = 36.34, SD = 4.48) and the control group (M = 37.46, SD = 5.21), with statistical significance (t = -6.395, 3.568, p < .001). Similarly, the mean score for exercise behavior in the experimental group (M = 36.88, SD = 8.29) was significantly higher than before the program (M = 29.76, SD = 10.93) and the control group (M = 28.26, SD = 8.44) (t = -4.135, 3.712, p < .001) Furthermore, the proportion of participants in the experimental group who had normal two-hour postprandial blood glucose levels (< 120 mg/dL) was significantly higher than that of the control group in weeks 3 and 5 (χ² = 4.282, p = .039; χ² = 9.028, p = .003). However, by week 7, there was no statistically significant difference between the two groups in the proportion of participants with normal blood glucose levels (χ² = 3.519, p = .061).

Recommendation Nurses and healthcare professionals can apply a self-management program via the LINE application to promote food consumption behavioral control, exercise, and glycemic control among pregnant women diagnosed with gestational diabetes mellitus, Class A1. This approach facilitates continuous monitoring of health behaviors, particularly through health alerts, the use of online manuals, and real-time feedback mechanisms.