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

Abstract

Gestational diabetes mellitus is the most common complication of pregnancy and contributes to increased risk for type 2 diabetes in both the mother and offspring. We developed and evaluated a gestational diabetes risk reduction and preconception counseling program, Stopping GDM (SGDM), for American Indian females. The purpose of this study is to examine the experiences of American Indian mother-daughter dyad participants and the site coordinators who facilitated the SGDM randomized controlled trial to inform program revisions. We engaged mother-daughter dyads ( n = 22 dyads) and site coordinators ( n = 6) in focus group interviews. Four themes emerged: (1) SGDM sparked valuable quality conversation for dyads; (2) gestational diabetes risk factors and risk reduction was new information for most dyads; (3) all trial sites experienced challenges to recruitment and engagement; and (4) study-improvement recommendations. These findings will be used to enhance SGDM to decrease adverse intergenerational health impacts of gestational diabetes in American Indian communities.

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

“…A dyadic team approach to PC for FAYAs and caregivers can be vital to addressing this lack of communication 21 . Indeed, a follow‐up qualitative study among caregiver‐FAYA dyads participating in the Stopping GDM trial found that the study's dyadic approach allowed caregivers and FAYAs more time for valuable communication 22 …”

“…21 Indeed, a follow-up qualitative study among caregiver-FAYA dyads participating in the Stopping GDM trial found that the study's dyadic approach allowed caregivers and FAYAs more time for valuable communication. 22 Informed by the qualitative findings and a feasibility pilot study, 4 the second phase of the Stopping GDM study was a randomized controlled trial (ClinicalTrials.gov NCT02723266) conducted from March 2018 to September 2019 and designed to test the efficacy of a psycho-behavioral educational intervention targeting healthy GDM risk reduction behaviors (eg, healthy eating, physical activity) in AIAN FAYAs at risk for GDM. The Stopping GDM study obtained approvals for the protection of human participants from multiple university and Tribal institutional review boards (IRBs) as well as an Indian Health Service Area Office IRB and the Indian Health Service National IRB.…”