Identifying Postpartum Intervention Approaches to Prevent Type 2 Diabetes in Women with a History of Gestational Diabetes

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Identifying Postpartum Intervention Approaches to Prevent Type 2 Diabetes in Women with a History of Gestational Diabetes

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Title: Identifying Postpartum Intervention Approaches to Prevent Type 2 Diabetes in Women with a History of Gestational Diabetes
Author: Abdul-Rahim, Zainab S; Rudloff, Noelle D; Mawson, Jacinda Mawson; Zera, Chloe Amelia; Seely, Ellen Wells; Levkoff, Sue Ellen; Mawson, Jacinda Mawson

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Citation: Nicklas, Jacinda M., Chloe A. Zera, Ellen W. Seely, Zainab S. Abdul-Rahim, Noelle D. Rudloff, and Sue E. Levkoff. 2011. Identifying postpartum intervention approaches to prevent type 2 diabetes in women with a history of gestational diabetes. BMC Pregnancy and Childbirth 11:23.
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Abstract: Background: Women who develop gestational diabetes mellitus (GDM) have an increased risk for the development of type 2 diabetes. Despite this "window of opportunity," few intervention studies have targeted postpartum women with a history of GDM. We sought perspectives of women with a history of GDM to identify a) barriers and facilitators to healthy lifestyle changes postpartum, and b) specific intervention approaches that would facilitate participation in a postpartum lifestyle intervention program. Methods: We used mixed methods to gather data from women with a prior history of GDM, including focus groups and informant interviews. Analysis of focus groups relied on grounded theory and used open-coding to categorize data by themes, while frequency distributions were used for the informant interviews. Results: Of 38 women eligible to participate in focus groups, only ten women were able to accommodate their schedules to attend a focus group and 15 completed informant interviews by phone. We analyzed data from 25 women (mean age 35, mean pre-pregnancy BMI 28, 52% Caucasian, 20% African American, 12% Asian, 8% American Indian, 8% refused to specify). Themes from the focus groups included concern about developing type 2 diabetes, barriers to changing diet, and barriers to increasing physical activity. In one focus group, women expressed frustration about feeling judged by their physicians during their GDM pregnancy. Cited barriers to lifestyle change were identified from both methods, and included time and financial constraints, childcare duties, lack of motivation, fatigue, and obstacles at work. Informants suggested facilitators for lifestyle change, including nutrition education, accountability, exercise partners/groups, access to gyms with childcare, and home exercise equipment. All focus group and informant interview participants reported access to the internet, and the majority expressed interest in an intervention program delivered primarily via the internet that would include the opportunity to work with a lifestyle coach. Conclusion: Time constraints were a major barrier. Our findings suggest that an internet-based lifestyle intervention program should be tested as a novel approach to prevent type 2 diabetes in postpartum women with a history of GDM. Trial Registration: ClinicalTrials.gov: NCT01102530
Published Version: doi:10.1186/1471-2393-11-23
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076295/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:7351762

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