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

Abstract

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.