Beyond the individual: Socio‐ecological factors impacting activity after gestational diabetes mellitus

Ioannou, Elysa; Humphreys, Helen; Homer, Catherine; Purvis, Alison

doi:10.1111/dme.15286

Cited by 3 publications

(1 citation statement)

References 65 publications

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“… 12 Social level variables may encompass community support, medical system, and societal attitudes towards disability or recovery. 23 Research highlights that a strong social network and a robust medical system can create environments that foster resourcefulness by offering necessary aid and resources. 24 Exploring the influencing factors of the trajectory patterns of resourcefulness from the perspective of the social-ecology model has important guiding significance for future intervention research.…”

Section: Introductionmentioning

confidence: 99%

Resourcefulness Among Initial Ischemic Stroke Patients: A Longitudinal Study of 12 Months

Guo,

Zauszniewski,

Zhang

et al. 2024

PPA

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Objective To explore distinct longitudinal trajectories of resourcefulness among initial ischemic stroke patients from diagnosis to 12 months, and to identify whether sociodemographic factors, disease-related factors, self-efficacy, family function, and social support can predict patterns in the trajectories of resourcefulness. Methods A prospective longitudinal study was conducted. Initial ischemic stroke patients who met inclusion and exclusion criteria were followed up when still in hospital (Preparing for discharge, Baseline, T1), at 1 month (T2), at 3 months (T3), at 6 months (T4), at 9 months (T5) and 12 months (T6) (±1 week) after discharge. General information, National Institute of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), General Self-Efficacy Scale (GSES), General Family Functioning Subscale (FAD-GF), and Social Support Rate Scale (SSRS) were used in T1. The Resourcefulness Scale © was evaluated at 6 time points. Growth mixture modeling was used to identify trajectory patterns of resourcefulness. Logistic regression was used to identify predictors of resourcefulness trajectories. Results Three longitudinal trajectories of resourcefulness were identified and named as the high-stable class (38.9%, n=71), fluctuation class (41.2%, n=75), and low-stable class (19.9%, n=36), respectively. Dwelling areas ( x 2 = 6.805, P= 0.009), education ( x 2 = 44.865, P= 0.000), monthly income ( x 2 = 13.063, P= 0.001), NIHSS scores ( x 2 = 44.730, P= 0.000), mRS scores ( x 2 = 51.788, P= 0.000), Hcy ( x 2 = 9.345, P= 0.002), GSES ( x 2 = 56.933, P= 0.000), FAD-GF ( x 2 = 41.305, P= 0.000) and SSRS ( x 2 =52.373, P= 0.000) were found to be statistically significant for distinguishing between different resourcefulness trajectory patterns. Lower education (OR=0.404), higher NIHSS(OR=6.672) scores, and higher mRS(OR=21.418) scores were found to be risk factors for lower resourcefulness, whereas higher education(OR=0.404), GSES(OR=0.276), FAD-GF(OR=0.344), and SSRS(OR=0.358) scores were identified as protective factors enhancing resourcefulness. Conclusion This study obtained three patterns of trajectories and identified their predictive fact...

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Section: Introductionmentioning

confidence: 99%

Resourcefulness Among Initial Ischemic Stroke Patients: A Longitudinal Study of 12 Months

Guo,

Zauszniewski,

Zhang

et al. 2024

PPA

View full text Add to dashboard Cite

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Preventing Type 2 Diabetes after Gestational Diabetes: A Systematic Review Mapping Physical Activity Components using the Socio-Ecological Model

Ioannou,

Humphreys,

Homer

et al. 2024

Matern Child Health J

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Objectives Gestational diabetes commonly occurs during pregnancy and increases lifetime risk of type 2 diabetes following pregnancy. Engaging in physical activity postnatally can reduce this subsequent risk. Interventions aiming to increase physical activity after gestational diabetes may not address the wide range of post-pregnancy barriers. A socio-ecological approach highlights the need to include multi-level factors such as social, community and organisational factors. The aim of the review was to map intervention components to prevent type 2 diabetes after gestational diabetes using the socio-ecological model as a framework and investigate how physical activity changes align with different intervention components utilised. Methods Eligible studies included any study type within 5 years of a gestational diabetes diagnosis and targeted physical activity. A systematic search of MEDLINE, Cochrane Library, Web of Science, CINAHL Complete, and Scopus was conducted in October 2022. Results were categorised based on whether findings demonstrated no increases, non-statistically significant increases or statistically significant increases in physical activity. Results Forty-eight studies were included (37 different interventions). Thirty-eight studies were assessed as “adequate” quality, only two studies were “good” quality, and the remaining were limited quality. Mixed physical activity outcomes were observed across components used at the intrapersonal level, with components across other levels of the socio-ecological model showing more increases in physical activity. Intervention components within the social and organisational levels, for example childcare provision, providing group-based sessions and offering remote delivery, were more often present in interventions with physical activity increases. Conclusions for Practice Future interventions targeting physical activity after gestational diabetes should aim to include social and organisational-level components in their intervention design. This systematic review was registered in PROSPERO (ID: CRD42021272044).

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Barriers and system improvements for physical activity promotion after gestational diabetes: A qualitative exploration of the views of healthcare professionals

Ioannou,

Humphreys,

Homer

et al. 2024

Diabet Med

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AimPhysical activity is an important behaviour for managing the ten times increased risk of type 2 diabetes after gestational diabetes. Previous studies exploring physical activity promotion in healthcare focus on general practitioners but have not explored the gestational diabetes pathway. Therefore, this paper explores the barriers to and suggestions for, activity promotion along the gestational diabetes healthcare pathway.MethodsThe paper was written in accordance with the Standards for Reporting Qualitative Research. Patient and Public Involvement with women who had lived experiences of gestational diabetes informed purposeful sampling by identifying which healthcare professional roles should be targeted in participant recruitment. Participants were recruited through word‐of‐mouth, that is, email and connections with local healthcare service leads. Twelve participants took part in semi‐structured one‐to‐one interviews, analysed using reflexive thematic analysis.ResultsParticipants included a Public Health Midwife (n = 1), Diabetes Midwifes (n = 3), Diabetes Dietitian (n = 1), Diabetes Consultants (n = 2), Diabetes Specialist Nurse (n = 1), general practitioners (n = 2), Practice nurse (n = 1) and a Dietitian from the UK National Diabetes Prevention Program (n = 1). Six themes were generated: ‘management of gestational diabetes takes precedent’, ‘poor continuity of care’, ‘lack of capacity to promote PA’, ‘beliefs about the acceptability of PA promotion’, ‘resources to support conversations about PA’ and ‘adapting healthcare services for women post‐gestational diabetes’.ConclusionsDuring pregnancy messaging around physical activity is consistent, yet this is specific for managing gestational diabetes and is not followed through postnatally. Improvements in continuity of care are necessary, in addition to ensuring the availability and links with wider exercise and activity schemes.

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Beyond the individual: Socio‐ecological factors impacting activity after gestational diabetes mellitus

Cited by 3 publications

References 65 publications

Resourcefulness Among Initial Ischemic Stroke Patients: A Longitudinal Study of 12 Months

Resourcefulness Among Initial Ischemic Stroke Patients: A Longitudinal Study of 12 Months

Preventing Type 2 Diabetes after Gestational Diabetes: A Systematic Review Mapping Physical Activity Components using the Socio-Ecological Model

Barriers and system improvements for physical activity promotion after gestational diabetes: A qualitative exploration of the views of healthcare professionals

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