Paths to improving care of Australian Aboriginal and Torres Strait Islander women following gestational diabetes

Campbell, Sandra, Roux, Nicolette, Preece, Cilla, Rafter, Eileen, Davis, Bronwyn, Mein, Jackie, Boyle, Jacqueline, Fredericks, Bronwyn, and Chamberlain, Catherine (2017) Paths to improving care of Australian Aboriginal and Torres Strait Islander women following gestational diabetes. Primary Health Care Research & Development, 18 (6). pp. 549-562.

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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.

Item ID: 51958
Item Type: Article (Research - C1)
ISSN: 1477-1128
Keywords: Australian, gestational diabetes mellitus, Indigenous, postpartum screening
Funders: Diabetes Queensland (DQ), National Health and Medical Research Council (NHMRC)
Projects and Grants: DQ 100358, NHMRC 1071889, NHMRC 1088813
Date Deposited: 10 Jan 2018 07:52
FoR Codes: 45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450414 Aboriginal and Torres Strait Islander mothers and babies health and wellbeing @ 70%
42 HEALTH SCIENCES > 4206 Public health > 420699 Public health not elsewhere classified @ 30%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes @ 100%
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