BackgroundGestational diabetes rates have increased dramatically in the past two decades and this pattern of increase appears to relate primarily to the obesity epidemic, older maternal age and migration from world areas of high GDM risk. Women from disadvantaged and migrant backgrounds are most at risk of developing and of mismanaging this condition. The aim of the study was to explore the factors that facilitated or inhibited gestational diabetes self-management among women in a socially deprived area.MethodsFifteen pregnant women, with a diagnosis of gestational diabetes, were purposively recruited for this study. Qualitative semi structured interviews and 1 focus group were conducted when participants were approximately 28–38 weeks gestation. The study’s theoretical framework was based on interpretative phenomenology and data was analysed using a thematic analysis approach.ResultsWomen in this study identified a number of factors that complicated their task of GDM self-management. Barriers included: (1) time pressures; (2) physical constraints; (3) social constraints; (4) limited comprehension of requirements, and (5) insulin as an easier option. Factors facilitating GDM self-management included: thinking about the baby and psychological support from partners and families.ConclusionWomen from low socio economic and migrant backgrounds often struggle to comprehend GDM self-management requirements. To improve adherence to management plans, these women require educational and supportive services that are culturally appropriate and aimed at a low level of literacy.

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Objective: To report the processes and outcomes of a case study on digital technology, diabetes and culturally and linguistically diverse (CALD) communities. Design: The qualitative study was based on a literature review, consultations and testing of a framework through workshops and an interactive information session. Setting: Consultations, workshops and an information session conducted in western regions of Melbourne, Victoria, Australia. Method: A framework was designed to address the needs of CALD community members to self-manage chronic conditions using innovative digital technology strategies. This was based on the literature review and 20 consultations held with representatives from health service providers and community organizations. The framework was tested with the assistance of the Quang Minh Buddhist Temple through consultations, workshops and an interactive information session about diabetes, YouTube and digital video cameras, in which 38 elderly women from the Vietnamese community participated. A descriptive and thematic analysis of participant feedback was conducted to determine lessons for future practice. Results: Participant feedback indicated that the information session achieved its goal of raising awareness of ways to use and access diabetes information using digital technology. However, participants noted areas for enhancement and improvement, including more focused and targeted engagement with peer-led techniques, the digital proficiency of participants and digital technology preferences based on age and cultural background. Conclusion: Digital technology was used to improve diabetes awareness information with elderly Vietnamese women, demonstrating the potential for application with others from CALD communities. However, there are continuing challenges in this approach, indicating the need for nuanced community engagement strategies that consider cultural context and familiarity with different kinds of digital technology.

Addressing racism within health systems and services is critical to addressing health vulnerabilities and promoting health equity for racialized populations. Currently, there is limited knowledge about the ways in which racism affects health services for adolescents. A scoping review was undertaken following the Joanna Briggs Institute Manual for Evidence Synthesis methodology and guided by the research questions: (1) What are the characteristics of the literature examining racism in health service use for adolescents? (2) What are the foci of the literature on systemic racism and health services for adolescents? A systematic literature search was conducted in April 2021 to identify all relevant published studies. The search identified 3049 unique articles, with a total of 13 articles included in this review. Multiple levels of racism were examined in the included articles across various health care settings. Five foci were identified: racism prevention, missed care, quality of care, racial bias, and experiences of racism. Our review indicates a current emphasis on interpersonal racism within this field of study, with emergent discussion of the impact of systemic racism. However, greater attention is needed that would investigate multiple forms of racism (institutional, interpersonal, internalized) in relation to specific contexts and adolescent populations.

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