Abstract
Women with gestational diabetes (GDM) have a fivefold higher risk of developing type 2 diabetes (T2DM). Furthermore, Hispanic and African-American women are disproportionately affected by GDM, but their views on prevention of T2DM after gestational diabetes are largely unknown. We conducted semi-structured interviews with 23 women (8 Hispanic, 8 African-American, 7 non-Hispanic White) from two academic clinics in Chicago, IL. Interview questions elicited perspectives on prevention of T2DM; the interview protocol was developed based on the Health Belief Model. Two investigators applied template analysis to identify emergent themes. Women conceptualized risk for T2DM based on family history, health behaviors, and personal history of GDM. A subgroup of women expressed uncertainty about how GDM influences risk for T2DM. Women who described a strong link between GDM and T2DM often viewed the diagnosis as a cue to action for behavior change. T2DM was widely viewed as a severe condition, and desire to avoid T2DM was an important motivator for behavior change. Children represented both a key motivator and critical barrier to behavior change. Women viewed preventive care as important to alert them to potential health concerns. Identified themes were congruent across racial/ethnic groups. Diagnosis with GDM presents a potent opportunity for engaging women in behavior change. To fully harness the potential influence of this diagnosis, healthcare providers should more clearly link the diagnosis of GDM with risk for future T2DM, leverage women’s focus on their children to motivate behavior change, and provide support with behavior change during healthcare visits in the postpartum period and beyond.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1526-1534 |
| Number of pages | 9 |
| Journal | Maternal and child health journal |
| Volume | 19 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 22 2015 |
Funding
We would like to thank the patients and staff of the Prentice Ambulatory Clinic, the Northwestern Medical Faculty Foundation Obstetrics and Gynecology Clinic, and the Northwestern Memorial Physician’s Group Obstetrics and Gynecology clinic. Dr. Tang was supported by a pilot grant through the Feinberg School of Medicine Center for Equity in Clinical Preventive Services (a Center of Excellence funded by the Agency of Healthcare Research and Quality P01 HS021141, David W. Baker, PI). The funding agency had no involvement in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. A portion of these results were previously presented at the 2013 SGIM National Meeting in Denver, CO.
Keywords
- Barriers and motivators
- Gestational diabetes
- Qualitative research
- Risk perception
- Type 2 diabetes
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Obstetrics and Gynecology
- Epidemiology
- Pediatrics, Perinatology, and Child Health
