Sandra Campbell1, Nicolette Roux2, Cilla Preece3, Eileen Rafter2, Bronwyn Davis4, Jackie Mein5, Jacqueline Boyle6, Bronwyn Fredericks7, Catherine Chamberlain3. 1. 1Centre for Chronic Disease Prevention,James Cook University,Smithfield,QLD,Australia. 2. 3Wuchopperen Health Service,Manoora,QLD,Australia. 3. 4Indigenous Health Equity Unit,School of Population and Global Health,University of Melbourne,Carlton,VIC,Australia. 4. 5School of Nursing, Midwifery & Nutrition,James Cook University,Smithfield,QLD,Australia. 5. 2Apunipima Cape York Health Council,Bungalow,QLD,Australia. 6. 6School of Public Health and Preventive Medicine,Monash Centre for Health Research and Implementation,Monash University,Melbourne, VIC,Australia. 7. 7Office of Indigenous Engagement,Central Queensland University,Rockhampton North,QLD,Australia.
Abstract
Aim To understand enablers and barriers influencing postpartum screening for type 2 diabetes following gestational diabetes in Australian Indigenous women and how screening might be improved. BACKGROUND: Australian Indigenous women with gestational diabetes mellitus (GDM) are less likely than other Australian women to receive postpartum diabetes screening. This is despite a fourfold higher risk of developing type 2 diabetes within eight years postpartum. METHODS: We conducted interviews with seven Indigenous women with previous GDM, focus groups with 20 Indigenous health workers and workshops with 24 other health professionals. Data collection included brainstorming, visualisation, sorting and prioritising activities. Data were analysed thematically using the Theoretical Domains Framework. Barriers are presented under the headings of 'capability', 'motivation' and 'opportunity'. Enabling strategies are presented under 'intervention' and 'policy' headings. Findings Participants generated 28 enabling environmental, educational and incentive interventions, and service provision, communication, guideline, persuasive and fiscal policies to address barriers to screening and improve postpartum support for women. The highest priorities included providing holistic social support, culturally appropriate resources, improving Indigenous workforce involvement and establishing structured follow-up systems. Understanding Indigenous women's perspectives, developing strategies with health workers and action planning with other health professionals can generate context-relevant feasible strategies to improve postpartum care after GDM. Importantly, we need evidence which can demonstrate whether the strategies are effective.
Aim To understand enablers and barriers influencing postpartum screening for type 2 diabetes following gestational diabetes in Australian Indigenous women and how screening might be improved. BACKGROUND: Australian Indigenous women with gestational diabetes mellitus (GDM) are less likely than other Australian women to receive postpartum diabetes screening. This is despite a fourfold higher risk of developing type 2 diabetes within eight years postpartum. METHODS: We conducted interviews with seven Indigenous women with previous GDM, focus groups with 20 Indigenous health workers and workshops with 24 other health professionals. Data collection included brainstorming, visualisation, sorting and prioritising activities. Data were analysed thematically using the Theoretical Domains Framework. Barriers are presented under the headings of 'capability', 'motivation' and 'opportunity'. Enabling strategies are presented under 'intervention' and 'policy' headings. Findings Participants generated 28 enabling environmental, educational and incentive interventions, and service provision, communication, guideline, persuasive and fiscal policies to address barriers to screening and improve postpartum support for women. The highest priorities included providing holistic social support, culturally appropriate resources, improving Indigenous workforce involvement and establishing structured follow-up systems. Understanding Indigenous women's perspectives, developing strategies with health workers and action planning with other health professionals can generate context-relevant feasible strategies to improve postpartum care after GDM. Importantly, we need evidence which can demonstrate whether the strategies are effective.
Authors: R Kirkham; N Trap-Jensen; J A Boyle; F Barzi; E L M Barr; C Whitbread; P Van Dokkum; M Kirkwood; C Connors; E Moore; P Zimmet; S Corpus; A J Hanley; K O'Dea; J Oats; H D McIntyre; A Brown; J E Shaw; L Maple-Brown Journal: BMC Pregnancy Childbirth Date: 2019-10-28 Impact factor: 3.007
Authors: Anna Wood; Diana MacKay; Dana Fitzsimmons; Ruth Derkenne; Renae Kirkham; Jacqueline A Boyle; Christine Connors; Cherie Whitbread; Alison Welsh; Alex Brown; Jonathan E Shaw; Louise Maple-Brown Journal: Int J Environ Res Public Health Date: 2020-01-22 Impact factor: 3.390