STEP-UP will promote linkage to primary care and ongoing chronic disease evaluation for postpartum women with prior gestational diabetes mellitus (GDM) and/or hypertensive disorders of pregnancy (HDP) by promoting:~counseling and referral to primary care, during OB visits, via electronic health record (EHR)-based clinical decision support (CDS)~dysglycemia testing for women with prior GDM, prompted via CDS during both OB and primary care visits~dissemination of understandable information on future risk and the need for ongoing evaluation generated automatically via the EHR and printed for patients with after-visit summaries (AVS)~motivational messaging and reminders supporting transitions of care delivered directly to patients via short message service (SMS) text messages~individualized outreach and support for those who need additional help arranging a primary care visit~The study's specific aims are to:~Aim 1 Test the effectiveness of STEP-UP, compared with usual care, to improve patient: 1) knowledge of reproductive risks associated with T2DM and recommended self-care activities; 2) engage in self-care behaviors, including diet, physical activity, adherence to diabetes medications, and use of folic acid and most or moderately effective contraception, when indicated; and 3) clinical measures, including hemoglobin A1c, blood pressure, and LDL cholesterol.~Aim 2 Investigate the heterogeneity of STEP-UP intervention effects by patients' race, ethnicity, and language.~Aim 3 Assess the reach, adoption, implementation, maintenance and costs of STEP-UP components.
STEP-UP will promote linkage to primary care and ongoing chronic disease evaluation for postpartum women with prior gestational diabetes mellitus (GDM) and/or hypertensive disorders of pregnancy (HDP).