The overall aim is to develop and test the feasibility of a novel interactive culturally appropriate digitalised DPI specific for GDM.

Workstream 1 (development phase): we will conduct a literature review of the process evaluations of RCTs of digitalised DPIs in GDM to identify implementation, mechanisms of action and contextual factors important in optimising effectiveness (study 1a). In parallel we will conduct a focus group with women with GDM and health care professionals to understand the barriers and facilitators of uptake of DPI, and solutions to optimise the DPI (study 1b). We will integrate these findings to develop a logic model of our digitalised DPI and use participatory learning and action methods to finalise the intervention including the contents of the DPI app (studies 1c & 1d). The key components of the DPI proposed are: initial face-to-face group session; online educational diabetes prevention curriculum appropriate for Malaysian culture; biofeedback of physical activity, diet and emotions levels; motivational SMS messages; chat function for women to communicate with each other; facilitation by a dietician trained in behaviour change techniques and supportive counselling; a manual.

Workstream 2: we will conduct an RCT comparing the DPI with usual care for 12 months for 60 women with current GDM to assess the feasibility of conducting a future full scale definitive effectiveness RCT (study 2).