"Post-GDM support would be really good for mothers": A qualitative interview study exploring how to support a healthy diet and physical activity after gestational diabetes.


Type
Article
Change log
Authors
Dennison, Rebecca A  ORCID logo  https://orcid.org/0000-0002-0847-0723
Usher-Smith, Juliet A 
Fox, Rachel A 
Aiken, Catherine E 
Abstract

BACKGROUND: Women with a history of gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes mellitus (T2DM). They are therefore recommended to follow a healthy diet and be physically active in order to reduce that risk. However, achieving and maintaining these behaviours in the postpartum period is challenging. This study sought to explore women's views on suggested practical approaches to achieve and maintain a healthy diet and physical activity to reduce T2DM risk. METHODS: Semi-structured interviews with 20 participants in Cambridgeshire, UK were conducted at three to 48 months after GDM. The participants' current diet and physical activity, intentions for any changes, and views on potential interventions to help manage T2DM risk through these behaviours were discussed. Framework analysis was used to analyse the transcripts. The interview schedule, suggested interventions, and thematic framework were based on a recent systematic review. RESULTS: Most of the participants wanted to eat more healthily and be more active. A third of the participants considered that postpartum support for these behaviours would be transformative, a third thought it would be beneficial, and a third did not want additional support. The majority agreed that more information about the impact of diet and physical activity on diabetes risk, support to exercise with others, and advice about eating healthily, exercising with a busy schedule, monitoring progress and sustaining changes would facilitate a healthy diet and physical activity. Four other suggested interventions received mixed responses. It would be acceptable for this support to be delivered throughout pregnancy and postpartum through a range of formats. Clinicians were seen to have important roles in giving or signposting to support. CONCLUSIONS: Many women would appreciate more support to reduce their T2DM risk after GDM and believe that a variety of interventions to integrate changes into their daily lives would help them to sustain healthier lifestyles.

Description
Keywords
Adult, Diabetes Mellitus, Type 2, Diabetes, Gestational, Diet, Healthy, Exercise, Female, Health Knowledge, Attitudes, Practice, Humans, Postpartum Period, Pregnancy, Pregnancy in Diabetics
Journal Title
PLoS One
Conference Name
Journal ISSN
1932-6203
1932-6203
Volume Title
17
Publisher
Public Library of Science (PLoS)
Sponsorship
Medical Research Council (MC_UU_12015/4)
Cancer Research UK (21464)
MRC (MR/T016701/1)
MRC (MC_UU_00006/6)
RAD was funded by a PhD studentship from the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR; SPCR-S-S102). This paper presents independent research funded by the NIHR SPCR. The views expressed are those of the author(s) and not necessarily those of the NIHR, the NHS or the Department of Health. JAUS was funded by a Cancer Research UK Cancer Prevention Fellowship (C55650/A21464). SJG is supported by the Medical Research Council (MC_UU_12015/4). The University of Cambridge has received salary support in respect of SJG from the NHS in the East of England through the Clinical Academic Reserve. CEA is supported by an Action Medical Research Grant (GN2778) and a Medical Research Council New Investigator Research Grant (MR/T016701/1). CLM is supported by the Diabetes UK Harry Keen Intermediate Clinical Fellowship (DUK-HKF 17/0005712) and the European Foundation for the Study of Diabetes – Novo Nordisk Foundation Future Leaders’ Award (NNF19SA058974). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.