Assessing Reproductive Health Knowledge in Female Adolescents with Diabetes

Abstract

Objective: Women with diabetes have increased risks of pregnancy-related complications. Knowledge of preventing these risks can be helpful. This paper describes the understanding and knowledge of diabetes and reproductive health of adolescent females with type 1 diabetes (T1D). Research Design and Methods:For this secondary analysis, a descriptive mixed-method design was employed using baseline data from adolescents enrolled in a preconception counseling (PC) intervention study (READY-Girls program) targeting adolescent women with diabetes to enhance reproductive health awareness, knowledge, beliefs, decision-making skills, and behaviors. Participants (aged 13-20 yrs) were recruited from 2 university-based diabetes clinics. Content analysis was used to identify recurring themes on 3 open-ended computer-based questions regarding the understanding of diabetes and pregnancy, contraception, and PC; kappa coefficients were used to assess inter-coder agreement. Subscale scores from multiple-choice vignettes were computed in terms of 100% correctness (<70% indicated low levels) for knowledge of diabetes and pregnancy, contraception, and PC. Qualitative and quantitative results were compared.Results: Participants (n=101) were on average 15.8 yrs, 21% were sexually active with a mean age at sexual debut of 15.3yrs. Overarching themes from qualitative data were that participants knew "little or nothing" and had misconceptions regarding diabetes and pregnancy, contraception, and PC. Inter-coder agreement for content analysis was high. Knowledge scores were low (diabetes and pregnancy, 64.5%; diabetes and contraception, 79.8%; PC, 67.5%).Conclusion: Risky behavior and low knowledge scores confirmed their perceived lack of understanding from the open-ended questions regarding diabetes and pregnancy and PC. Teens had greater knowledge of contraception. Diabetes education should include PC and reproductive health for teens with diabetes.

It Takes a Brain, a Heart, Courage, and Support

“…Since 2009, the American Diabetes Association has included in its annual Standards of Medical Care in Diabetes a recommendation stating that, "Starting at puberty, preconception counseling should be incorporated into routine diabetes care for all girls of childbearing potential" (10). I am proud that our research with the READY-Girls program provided the evidence base to support that recommendation (8,11).…”

“…For these reasons, we also need to provide preconception care knowledge and skills to both HCPs and mothers. We offer continuing education programs for HCPs on our University of Pittsburgh School of Nursing website (www.nursing.pitt.edu), and READY-Girls materials specially adapted for the ADA (11) are available free of charge on its website (www. diabetes.org/ReadyGirls).…”

The Associations Between Health‐Related Knowledge and Health Beliefs Regarding Risk for Gestational Diabetes in American Indian and Alaska Native Female Adolescents and Young Adults at Risk for Gestational Diabetes and Their Female Caregivers: A Cross‐Sectional Dyadic Analysis

“…Both the READY-Girls and communication programs were developed to be culturally sensitive for African American women. 11 Due to the vital role mothers can play in their daughters' RH, 13 it is essential to use dyadic analyses to better understand the possible influence of mothers on their daughters' knowledge and health beliefs about GDM. Dyadic analytic approaches allow for the investigation of intrapersonal relations within a dyad member (ie, actor effects) as well as interpersonal associations between members of a dyad (ie, partner effects).…”

The Experiences of American Indian Participants and Site Coordinators in a Gestational Diabetes Risk Reduction Trial

“…Our study team developed a culturally informed, theory-and evidence-based GDM risk reduction and preconception counseling program titled "Stopping Gestational Diabetes in Daughters and Mothers: A Gestational Diabetes Risk Reduction and Preconception Counseling Program for American Indian and Alaska Native Daughters and Mothers" (SGDM). This program is based on the University of Pittsburgh's previous evidence-based preconception counseling intervention READY-Girls (Downs & Charron-Prochownik, 2008), which is endorsed by the American Diabetes Association as the standard of care for providing preconception counseling for girls with type 1 or T2D (Charron-Prochownik & Downs, 2016). SGDM includes developmentally and culturally appropriate preconception counseling to prevent unplanned pregnancies and risk reduction strategies for GDM.…”