Analysis of spontaneous, user‐generated data about gestational diabetes on online forums: implications for diabetes prevention

Eades, Claire E; Clarke, Kathleen M; Cameron, Dawn M; Coulson, Neil; Evans, Josie

doi:10.1111/dme.14348

Cited by 10 publications

(12 citation statements)

References 23 publications

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“…Although there may have been some variations in provision of care to women with GDM between the Health Boards, their views and experiences surrounding the topic seemed fairly consistent. They also chimed well with findings from other studies in a variety of settings, which suggest that many women with GDM, for various reasons, do not recognise the serious long-term implications of their GDM diagnosis [4][5][6][7][8]. Our findings respond to the recognition that a shift in perception of GDM is needed [13], from one where it is assumed to be a treatable short-term condition, to one that has the potential to influence the long-term health of mothers and their children in the future.…”

Section: Discussionsupporting

confidence: 77%

“…While reduced risk of T2D after GDM has been documented in women who have successfully made improvements to diet and physical activity levels post-delivery, effective interventions within heath care settings to achieve this are intensive and costly [ 4 ]. We have recently completed qualitative research that has identified that there are illness perceptions surrounding GDM that, if they are not addressed, are likely to compromise the effect of lifestyle interventions [ 5 , 6 ]. For example, although many women know that there is an association between GDM and T2D, they may not perceive themselves personally as being at increased risk.…”

Section: Introductionmentioning

confidence: 99%

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Postpartum opportunistic advice in primary care for women who have had gestational diabetes: a qualitative study of health care professionals’ views

et al. 2021

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Background Women who have had gestational diabetes during pregnancy are at very high risk of developing type 2 diabetes later in life, but their understanding of the risks is often limited. In this study we explored the views of health care professionals regarding offering brief opportunistic advice to women after their pregnancy, during unrelated consultations in primary care, relating to reducing diabetes risk. Methods The study took place in three Health Boards in Scotland. We conducted semi-structured one-to-one interviews (either face-to-face or telephone) with two health visitors, three practice nurses, two GPs, two diabetes consultants and two obstetricians. A focus group with five health visitors was also held. A topic guide was followed, covering the feasibility and acceptability of delivering brief opportunistic advice during a routine consultation, the optimal way to identify and recall women with previous gestational diabetes, and the possible content and timing of any such intervention. A thematic approach was used to analyse the qualitative data generated. Results The interviews/discussion lasted from 15 to 51 min. There was widespread support from all participants for offering opportunistic advice, and general consensus that health visitors would be best placed to do this as part of the Universal Health Visiting Pathway in Scotland. Thematic analysis generated three significant points of discussion: implications for training of health visitors, the need for a systematic approach to identifying women with gestational diabetes, and the optimal timing of delivery. Despite an already demanding schedule of providing advice and education to women, health visitors were confident that they could offer educational advice, provided that they received appropriate training to do so. However, there would need to be a watertight system for identifying women in their care who had had gestational diabetes. In terms of timing, later visits around 6–8 months after delivery were considered most suitable. Conclusions There is support from health care professionals, and most pertinently from health visitors, that the frequency of routine visits with women during the Universal Health Visiting Pathway programme in Scotland provides potential opportunities for education around future diabetes risk to women who have had gestational diabetes.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Postpartum opportunistic advice in primary care for women who have had gestational diabetes: a qualitative study of health care professionals’ views

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Although there may have been some variations in provision of care to women with GDM between the Health Boards, their views and experiences surrounding the topic seemed fairly consistent. They also chimed well with ndings from other studies in a variety of settings, which suggest that many women with GDM, for various reasons, do not recognise the serious long-term implications of their GDM diagnosis [3][4][5][6][7] . However, we used an opt-in convenience sampling, so we cannot be sure how widespread the views of our participants were, nor whether those HCPs who opted in were those with particularly strong views or an interest in the topic.…”

Section: Discussionsupporting

confidence: 73%

“…We have recently completed qualitative research that has identi ed that there are illness perceptions surrounding GDM that, if they are not addressed, are likely to compromise the effect of lifestyle interventions 4,5 . For example, although many women know that there is an association between GDM and T2D, they may not perceive themselves personally as being at increased risk.…”

Section: Introductionmentioning

confidence: 99%

Postpartum brief educational interventions for women who have had gestational diabetes: a qualitative study of of health care professionals’ views

Evans

Ireland

Cameron

et al. 2021

Preprint

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Background Women who have had gestational diabetes during pregnancy are at very high risk of developing type 2 diabetes later in life, but their understanding of the risks is often limited. In this study we explored the views of health care professionals regarding offering brief opportunistic advice to women after their pregnancy, during unrelated consultations in primary care, relating to reducing diabetes risk. Methods The study took place in three Health Boards in Scotland. We conducted semi-structured one-to-one interviews (either face-to-face or telephone) with three health visitors, three practice nurses, two GPs, two diabetes consultant and two obstetricians. A focus group with five health visitors was also held. A topic guide was followed, covering the feasibility and acceptability of delivering a brief educational intervention during a routine consultation, the optimal way to identify and recall women with previous gestational diabetes, and the possible content and timing of the intervention. A thematic approach was used to analyse the qualitative data generated. Results The interviews/discussion lasted from 15 to 66 minutes. There was widespread support for such an intervention from all participants and general consensus that health visitors would be best placed to offer educational advice and support as part of the Health Visiting Pathway in Scotland. Thematic analysis generated three significant points of discussion: implications for training of health visitors, the need for a systematic approach to identifying women with gestational diabetes, and the optimal timing of delivery. Despite an already demanding schedule of providing advice and education to women, health visitors were confident that they could offer educational advice, provided that they received appropriate training to do so. However, there would need to be a watertight system for identifying women in their care who had had gestational diabetes. In terms of timing, later visits around 6–8 months after delivery were considered most suitable. Conclusions There is support from health care professionals, and most pertinently from health visitors, that the frequency of routine visits with women during the Health Visiting Pathway programme in Scotland provides potential opportunities for education around future diabetes risk to women who have had gestational diabetes.

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“…Information was accessible at all times and could be informative and supportive, but many users raise doubts about trustworthiness [42,44,45]. A recent analysis of posts on Mumsnet and Netmums forums concluded that the support provided does not encourage T2DM prevention because diabetes risk was rarely discussed and users downplayed the seriousness of GDM and its association with lifestyle behaviours [46]. Instead of searching for such groups themselves, mothers could be directed to reliable resources by a trusted professional or body.…”

Section: Implications For Practicementioning

confidence: 99%

“Post-GDM support would be really good for mothers”: A qualitative interview study exploring how to support a healthy diet and physical activity after gestational diabetes

et al. 2022

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Background Women with a history of gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes mellitus (T2DM). They are therefore recommended to follow a healthy diet and be physically active in order to reduce that risk. However, achieving and maintaining these behaviours in the postpartum period is challenging. This study sought to explore women’s views on suggested practical approaches to achieve and maintain a healthy diet and physical activity to reduce T2DM risk. Methods Semi-structured interviews with 20 participants in Cambridgeshire, UK were conducted at three to 48 months after GDM. The participants’ current diet and physical activity, intentions for any changes, and views on potential interventions to help manage T2DM risk through these behaviours were discussed. Framework analysis was used to analyse the transcripts. The interview schedule, suggested interventions, and thematic framework were based on a recent systematic review. Results Most of the participants wanted to eat more healthily and be more active. A third of the participants considered that postpartum support for these behaviours would be transformative, a third thought it would be beneficial, and a third did not want additional support. The majority agreed that more information about the impact of diet and physical activity on diabetes risk, support to exercise with others, and advice about eating healthily, exercising with a busy schedule, monitoring progress and sustaining changes would facilitate a healthy diet and physical activity. Four other suggested interventions received mixed responses. It would be acceptable for this support to be delivered throughout pregnancy and postpartum through a range of formats. Clinicians were seen to have important roles in giving or signposting to support. Conclusions Many women would appreciate more support to reduce their T2DM risk after GDM and believe that a variety of interventions to integrate changes into their daily lives would help them to sustain healthier lifestyles.

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Analysis of spontaneous, user‐generated data about gestational diabetes on online forums: implications for diabetes prevention

Cited by 10 publications

References 23 publications

Postpartum opportunistic advice in primary care for women who have had gestational diabetes: a qualitative study of health care professionals’ views

Postpartum opportunistic advice in primary care for women who have had gestational diabetes: a qualitative study of health care professionals’ views

Postpartum brief educational interventions for women who have had gestational diabetes: a qualitative study of of health care professionals’ views

“Post-GDM support would be really good for mothers”: A qualitative interview study exploring how to support a healthy diet and physical activity after gestational diabetes

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