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Adults with developmental disabilities face barriers to making healthy lifestyle choices that mirror the barriers faced by the direct support professionals who serve them. These two populations, direct support professionals and adults with developmental disabilities, are likely to lead inactive lifestyles, eat unhealthy diets, and be obese. Moreover, direct support professionals influence the nutrition knowledge, attitudes, and health behaviors of the adults with developmental disabilities whom they serve. We piloted a cooking-based nutrition education program, Cooking Matters for Adults , to dyads of adults with developmental disabilities (n = 8) and direct support professionals (n = 7). Team-taught by a volunteer chef and nutrition educator, Cooking Matters for Adults uses an active learning approach to teach food preparation safety skills and nutrition knowledge to inform healthy food and beverage choices. We assessed healthy food preparation, intake of a balanced diet, healthy food and beverage choices, and cooking confidence and barriers at pre-test, post-test, and 6-months after the intervention. Among both adults with developmental disabilities and direct support professionals, positive trends in healthy food preparation, eating a balanced diet, and reduction in cooking barriers were observed at post-test and 6-months. We also qualitatively assessed knowledge of and attitudes toward healthy eating, frequency of food and beverage intake, knowledge about kitchen skills and safety, as well as overall satisfaction, cooking confidence, and acceptability of the dyad approach. Participants with developmental disabilities and direct support professionals reported that they learned about healthy food and beverage choices and various cooking skills. Participants reported confidence in skills learned and were satisfied with the intervention and approach of including adults with developmental disabilities and direct support professionals in the intervention together.

Objectives To improve clinical practice and increase postpartum visit Type 2 diabetes mellitus (T2DM) screening rates in women with a history of gestational diabetes mellitus (GDM). Methods We recruited clinical sites with at least half of pregnant patients enrolled in Medicaid to participate in an 18-month quality improvement (QI) project. To support clinical practice changes, we developed provider and patient toolkits with educational and clinical practice resources. Clinical subject-matter experts facilitated a learning network to train sites and promote discussion and learning among sites. Sites submitted data from patient chart reviews monthly for key measures that we used to provide rapid-cycle feedback. Providers were surveyed at completion regarding toolkit usefulness and satisfaction. Results Of fifteen practices recruited, twelve remained actively engaged. We disseminated more than 70 provider and 2345 patient toolkits. Documented delivery of patient education improved for timely GDM prenatal screening, reduction of future T2DM risk, smoking cessation, and family planning. Sites reported toolkits were useful and easy to use. Of women for whom postpartum data were available, 67 % had a documented postpartum visit and 33 % had a postpartum T2DM screen. Lack of information sharing between prenatal and postpartum care providers was are barriers to provision and documentation of care. Conclusions for Practice QI and toolkit resources may improve the quality of prenatal education. However, postpartum care did not reach optimal levels. Future work should focus on strategies to support coordination of care between obstetrical and primary care providers.

Purpose: The purpose of this study is to characterize mothers’ experiences within a mother/infant dyad postpartum primary care program (Dyad) following gestational diabetes mellitus (GDM) to inform improvements in the delivery of care. Methods: A qualitative pilot study of women (n = 10) enrolled in a mother/infant Dyad program was conducted in a primary care practice at a large, urban academic medical center. Respondents were asked a series of open-ended questions about their experience with GDM, the Dyad program, and health behaviors. Interviews were audio-recorded, transcribed verbatim, and analyzed using ground theory with NVivo 12 Plus software. Results: Three key themes emerged: (1) Dyad program experience, (2) implementation of health behavior changes, and (3) acknowledgment of future GDM and type 2 diabetes mellitus (T2DM) health risks. Respondents found the Dyad program respondents felt that the program conveniently served mother and infant health care needs in a single appointment. Respondents also valued support from primary care providers when implementing health behavior changes. The Dyad program provided an opportunity for respondents to understand their current and future risk for developing GDM and T2DM. Conclusions: Postpartum women enrolled in the Dyad program received highly personalized primary care services. The results of our study will help integrate patient-centered strategies into models for GDM care to maintain patient engagement in postpartum clinical services.

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