A Theory-based Reproductive Health and Diabetes Instrument

Charron‐Prochownik, Denise; Wang, Shiaw-Ling; Sereika, Susan M.; Kim, Yookyung; Janz, Nancy K.

doi:10.5993/ajhb.30.2.10

Cited by 34 publications

(56 citation statements)

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“…Program effectiveness was measured by assessing cognitive, psychosocial, and behavioral outcomes based on the Expanded Health Belief Model (6,8,9). These included reproductive health and preconception counseling knowledge and attitudes (perceived susceptibility to an unplanned pregnancy and pregnancy complications, perceived severity of those consequences, perceived benefit of and barriers to prevent an unplanned pregnancy and seeking preconception counseling, self-efficacy to use effective family planning methods and in seeking preconception counseling, and motivational cues).…”

Section: Methodsmentioning

confidence: 99%

“…In 2009, the American Diabetes Association recommended that all women with diabetes of childbearing potential receive preconception counseling and that this counseling start at puberty (2). In a previous study, we developed a preconception counseling program called READY-Girls (Reproductive-health Education and Awareness of Diabetes in Youth for Girls), tailored for teens with diabetes, and conducted a one-session intervention with a 3-month follow-up evaluation (4–6). Immediately after the session, teens who received the intervention improved in knowledge, attitudes, and intentions related to diabetes and reproductive health.…”

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confidence: 99%

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Impact of a Preconception Counseling Program for Teens With Type 1 Diabetes (READY-Girls) on Patient-Provider Interaction, Resource Utilization, and Cost

et al. 2010

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OBJECTIVETo evaluate the impact of a preconception counseling program tailored for teens with type 1 diabetes on cognitive, psychosocial, and behavioral outcomes and to assess its cost-effectiveness.RESEARCH DESIGN AND METHODSA total of 88 teens with type 1 diabetes from two sites were randomized into the READY-Girls (Reproductive-health Education and Awareness of Diabetes in Youth for Girls) intervention (IG) (n = 43) or standard care (SC) (n = 45) groups. During three diabetes clinic visits, IG subjects viewed a two-part CD-ROM, read a book, and met with a nurse. Program effectiveness was measured by knowledge, attitudes, intentions, and behaviors regarding diabetes, pregnancy, sexuality, and preconception counseling. Assessments occurred at baseline, before and after viewing program materials, and at 9 months. Economic analyses included an assessment of resource utilization, direct medical costs, and a break-even cost analysis.RESULTSAge range was 13.2–19.7 years (mean ± SD 16.7 ± 1.7 years); 6% (n = 5) were African American, and 24% (n = 21) were sexually active. Compared with baseline and SC subjects, IG subjects demonstrated a significant group-by-time interaction for benefit and knowledge of preconception counseling and reproductive health: increasing immediately after the first visit (P < 0.001) and being sustained for 9 months (P < 0.05 benefits; P < 0.001 knowledge). For IG subjects, preconception counseling barriers decreased over time (P < 0.001), and intention and initiation of preconception counseling and reproductive health discussions increased (P < 0.001). Costs of adverse reproductive outcomes are high. Direct medical costs of READY-Girls were low.CONCLUSIONSREADY-Girls was beneficial and effects were sustained for at least 9 months. This low-cost self-instructional program can potentially empower young women with type 1 diabetes to make well-informed reproductive health choices, adding little time burden or cost to their diabetes management.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Impact of a Preconception Counseling Program for Teens With Type 1 Diabetes (READY-Girls) on Patient-Provider Interaction, Resource Utilization, and Cost

et al. 2010

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“…Each dimension was a composite score (higher scores ϭ greater levels of the construct). Outcomes were assessed at baseline, immediately postintervention (post-test 1), and at 3-month follow-up (post-test 2) by paper-and-pencil selfadministered questionnaires (Cronbach's ␣ ϭ 0.65-0.83) based on a standard validated interview schedule (22)(23). Data were analyzed using descriptive statistics, group comparative analyses, and repeated-measures mixed-modeling methods (24).…”

Section: Methodsmentioning

confidence: 99%

Randomized Efficacy Trial of Early Preconception Counseling for Diabetic Teens (READY-Girls)

et al. 2008

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OBJECTIVE -To develop and assess the feasibility of an early preconception counseling program for adolescents called READY-Girls (Reproductive-health Education and Awareness of Diabetes in Youth for Girls).RESEARCH DESIGN AND METHODS -A total of 53 adolescent females with type 1 diabetes between 16 and 19.9 years of age were randomized into groups receiving a CD-ROM, a book, or standard care (control) and given one comprehensive session. Outcomes were assessed at baseline, immediately after, and at 3 months.RESULTS -Teens who received the CD and those who received the book demonstrated significant (P Յ 0.05) sustained improvement (over 3 months) in knowledge, perceived benefits of both receiving preconception counseling and using effective family planning, and perceived more support with reproductive health issues.CONCLUSIONS -Clinical feasibility of the program was demonstrated. Both the CD and the book appeared to be efficacious formats for the short term. Future studies should examine repeated boosters of a CD and a book, which are not meant to replace but rather to reinforce and supplement health professional education.

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“…Innovative research is needed to determine the methods of eliminating the barriers and achieving these goals (Charron-Prochownik et al, 2006a, 2006b, 2006cCothran et al, 2009;Fischl et al, 2010), including motivation offered by health care payers. An obvious need in many localities is health insurance coverage for all women with diabetes, in advance of pregnancy.…”

Section: Analysis Of Problems In the Application Of Preconception Carmentioning

confidence: 99%

Preconception care for women with diabetes and prevention of major congenital malformations

Kitzmiller¹,

Wallerstein

Correa

et al. 2010

Birth Defects Research

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This article provides an overview of the rationale for diabetes preconception care interventions for women with diabetes and the efficacy in reducing the excess occurrence of major congenital malformations. The problems with broad use of individualized preconception care are considered. In addition, suggestions are made for the implementation of more comprehensive interventions in the community and usual diabetes care settings, to address the multiple ongoing challenges in the prevention of structural anomalies associated with preexisting diabetes. Based on the published evidence, successful preconception care can be considered to include: achievement of individualized target standardized glycosylated hemoglobin levels, adequate nutrition, and minimizing hypoglycemia before and after discontinuing effective contraception and during the transition to early prenatal care.

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A Theory-based Reproductive Health and Diabetes Instrument

Cited by 34 publications

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Impact of a Preconception Counseling Program for Teens With Type 1 Diabetes (READY-Girls) on Patient-Provider Interaction, Resource Utilization, and Cost

Impact of a Preconception Counseling Program for Teens With Type 1 Diabetes (READY-Girls) on Patient-Provider Interaction, Resource Utilization, and Cost

Randomized Efficacy Trial of Early Preconception Counseling for Diabetic Teens (READY-Girls)

Preconception care for women with diabetes and prevention of major congenital malformations

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