Barriers to a healthy lifestyle post gestational-diabetes: An Australian qualitative study

Abstract

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms 1 Barriers to a healthy lifestyle post gestational-diabetes: an Australian qualitative study. 2 AbstractBackground: Overseas-born-women from certain ethnicities are at high risk of type-2 diabetes and related metabolic disorders. This study explored the barriers and facilitators to long-term healthy lifestyle recommendations among Australian-born and overseas-born-women who attended health promotion sessions at a tertiary Australian Hospital for gestational diabetes 3-4 years previously.Method; Face-to-face semi-structured interviews were conducted. Data were analyzed to identify major themes and the differing experiences of both groups of women. Conclusion.A better understanding of the barriers to healthy lifestyle by women in their everyday lives will assist in the development of culturally appropriate health promotion guidelines and strategies. Constant un-fragmented postnatal engagement by the specialised diabetes clinics and primary health care services is crucial to sustain the healthy lifestyle in the long-term for women with previous gestational-diabetes.

Women's views on lifestyle changes to reduce the risk of developing Type 2 diabetes after gestational diabetes: a systematic review, qualitative synthesis and recommendations for practice

“….' General lack of support, particularly in migrant populations, could result in isolation, depression and abandonment because women avoided social eating or dropped their diets in certain situations [29]. In particular, family could be a source of information about healthy diet such as the nutritional content of food.…”

Prevention of Type 2 diabetes after gestational diabetes directed at the family context: a narrative review from the Danish Diabetes Academy symposium

“…However, sustainable changes in such health behaviours are difficult and many women with GDM do not follow the recommendations after delivery [27]. Several studies have investigated the various factors that inhibit engagement in recommended healthy behaviours among women with prior GDM [28][29][30][31][32][33][34][35]. Several studies have investigated the various factors that inhibit engagement in recommended healthy behaviours among women with prior GDM [28][29][30][31][32][33][34][35].…”

“…The concept of susceptibility or risk perception is prominent in theories and models of health behaviour change building upon or incorporating the Health Belief Model [36] and has also found its way into research on health behaviours in women with prior GDM [27,37]. Some women appear to simply not be aware of the long-term risk of Type 2 diabetes and/or have the understanding that their condition -GDMis now over and done with; wherefore, there is no need to worry about or contemplate future diabetes [33,38]. Qualitative studies have shed light on various perceptions about susceptibility in this group.…”

“…In a US study, Kim and colleagues [37] found that only 16% of women with a history of GDM believed themselves to be at high risk of diabetes, and that those who perceived themselves to be at no or slight risk were less likely to change behaviours. Others recall being made aware of future risk but then experience a lack of concern, attention and focus from the healthcare system and providers after the delivery that is interpreted, at least by some, as the risk being no cause for concern, worry or action [33]. Some women appear to simply not be aware of the long-term risk of Type 2 diabetes and/or have the understanding that their condition -GDMis now over and done with; wherefore, there is no need to worry about or contemplate future diabetes [33,38].…”

“…Qualitative studies from various countries have highlighted the importance of culturally appropriate diet recommendations for women from ethnic minority groups [33,34,38]. Women with GDM constitute a diverse group with characteristics such as age, BMI and ethnicity being important risk factors.…”