A qualitative study exploring women's health behaviours after a pregnancy with gestational diabetes to inform the development of a diabetes prevention strategy. Issue 2 (22nd August 2018) - Parsons, J.
Abstract: Aim: To inform targeted interventions for women with gestational diabetes mellitus (GDM) by exploring the factors that influence their health behaviours and their preferences for lifestyle support. Methods: Participants were women with previous GDM taken from a diverse inner‐city UK population. Data collection involved focus groups (n = 35 women in six groups) and semi‐structured interviews (n = 15 women). The transcribed data were analysed using framework analysis. Results: Eight themes relating to factors influencing health behaviour were identified: psychological legacy of pregnancy, relationships with healthcare professionals, physical impacts of pregnancy, social support and cultural norms, life‐scheduling, understanding and risk perception, appetite regulation, and prioritization of the baby. The women's recommendations for intervention components included addressing the emotional stress of pregnancy; conveying personalized risk in a motivational way, adopting a family‐centered approach, focusing on women's health rather than just the infant's, and developing flexible interventions. These recommendations were used to construct a model integrating the behaviour‐regulating factors with a suggested framework for intervention. Conclusions: This study identified some common drivers that may regulate the health behaviours of women following GDM, and recognized some ways to improve care to impact on this. Interventions for diabetes prevention in this population need to address factors at both the individual and systemic levels. What's new?: This qualitative study exploring the diverse experiences of 50 women with previous gestational diabetes found that pregnancy experience had a potentially significant impact on maternal diet‐ and care‐seeking behaviours after birth. Lack of medical follow‐up after pregnancy reinforced the view that women's health is unimportant, and failed to capitalize on positive changes to health behaviour made during pregnancy. Interventions to help prevent future diabetes in this population should address emotional stress, convey personalized risk, adopt a family‐centred approach, focus more on the mother's health rather than just the infant's, and be flexible with a range of resources.