The ENCOURAGE healthy families study: A comparative effectiveness trial to reduce risk for type 2 diabetes in mothers and children

Introduction: Trials in adults have demonstrated that interventions targeting lifestyle are effective in preventing or delaying type 2 diabetes (T2D). To address this need in youth, we developed ENCOURAGE Healthy Families (ENCOURAGE), based on the US Diabetes Prevention Program (DPP). Study Design: Here, we present results of the ENCOURAGE randomized, comparative effectiveness trial in which we evaluated ENCOURAGE delivered to (1) mothers only, and (2) mothers with added content delivered to their children. Participants: The study was performed in Indianapolis, IN, at an academic medical center and the YMCA; December 2012 to April 2016. Women with a history of gestational diabetes mellitus (GDM) or prediabetes with children aged 8 to 15 years enrolled (n = 128). Outcome Measures: Outcomes were collected at baseline, postintervention (3 months), 6 and 12 months. The primary outcome was weight change at 3 months in adults; secondary outcomes included glycosylated hemoglobin (HbA1c), lipids, and blood pressure. Results: In neither program did mothers' weight change. HbA1c decreased at 3 months in both groups (mothers only=−0.09%, P =.019; mothers and children=−0.11%, P =.003). Participating children had a reduction in body mass index (BMI) percentile at 3 (−1.77, P =.014), 6 (−3.0, P =.002), and 12 months (−2.91, P =.004). HbA1c decreased in children in both groups (mothers only = −0.12% at 3 months [P <.0001], −0.13% at 6 months [P <.001], and −0.07% at 12 months [P =.001]; mothers and children = −0.08% at 3 months (P <.0001), −0.07% at 6 months (P =.0004), and −0.04% at 12 months (P =.03). Conclusion: ENCOURAGE was beneficial for reducing BMI percentile in participating children.