Lynn M Yee1, Jamie M McGuire2, Shaneah M Taylor2, Charlotte M Niznik3, Melissa A Simon4. 1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: lynn.yee@northwestern.edu. 2. Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL. 3. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL. 4. Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.
Abstract
OBJECTIVE: To identify social and environmental barriers to nutrition therapy for diabetes management during pregnancy among a population of low-income, minority pregnant women. DESIGN: Prospective, in-depth, semi-structured interviews performed serially during pregnancy and continued until thematic saturation was reached. SETTING: Urban academic medical center. PARTICIPANTS: Ten pregnant low-income, minority women with gestational diabetes and type 2 diabetes mellitus. PHENOMENON OF INTEREST: Social and environmental barriers to nutrition therapy for diabetes management during pregnancy. ANALYSIS: Qualitative analysis of interview data using electronic coding software was performed using theme analysis. RESULTS: Participants perceived limited ability and self-efficacy to adopt nutrition recommendations. Specific themes identified as barriers included (1) feeling overwhelmed by the unfamiliar; (2) using and decoding nutrition labels; (3) managing nutrition choices and seeking control in the setting of food insecurity; (4) experiencing lack of control and motivation, and limited self-efficacy; (5) balancing recommendations with taste preferences and cultural food norms; (6) maintaining a healthy eating schedule; and (7) accommodating diabetes in family and social life. CONCLUSIONS AND IMPLICATIONS: Pregnant women with diabetes encounter a number of knowledge-based, attitudinal, and resource-related barriers that reduce capacity for nutrition therapy adherence. Provision of culturally informed, practical nutrition support that addresses the needs of women in low-resource communities is an important component of comprehensive diabetes care during pregnancy.
OBJECTIVE: To identify social and environmental barriers to nutrition therapy for diabetes management during pregnancy among a population of low-income, minority pregnant women. DESIGN: Prospective, in-depth, semi-structured interviews performed serially during pregnancy and continued until thematic saturation was reached. SETTING: Urban academic medical center. PARTICIPANTS: Ten pregnant low-income, minority women with gestational diabetes and type 2 diabetes mellitus. PHENOMENON OF INTEREST: Social and environmental barriers to nutrition therapy for diabetes management during pregnancy. ANALYSIS: Qualitative analysis of interview data using electronic coding software was performed using theme analysis. RESULTS:Participants perceived limited ability and self-efficacy to adopt nutrition recommendations. Specific themes identified as barriers included (1) feeling overwhelmed by the unfamiliar; (2) using and decoding nutrition labels; (3) managing nutrition choices and seeking control in the setting of food insecurity; (4) experiencing lack of control and motivation, and limited self-efficacy; (5) balancing recommendations with taste preferences and cultural food norms; (6) maintaining a healthy eating schedule; and (7) accommodating diabetes in family and social life. CONCLUSIONS AND IMPLICATIONS: Pregnant women with diabetes encounter a number of knowledge-based, attitudinal, and resource-related barriers that reduce capacity for nutrition therapy adherence. Provision of culturally informed, practical nutrition support that addresses the needs of women in low-resource communities is an important component of comprehensive diabetes care during pregnancy.
Authors: Karoline Kragelund Nielsen; Thilde Vildekilde; Anil Kapur; Peter Damm; Veerasamy Seshiah; Ib C Bygbjerg Journal: Int J Environ Res Public Health Date: 2020-04-28 Impact factor: 3.390
Authors: Sarah A Stotz; Katharine A Ricks; Stephanie A Eisenstat; Deborah J Wexler; Seth A Berkowitz Journal: Sci Diabetes Self Manag Care Date: 2021-02-28