Identifying postpartum intervention approaches to prevent type 2 diabetes in women with a history of gestational diabetes
Open accessAbstract
BACKGROUND: Women who develop gestational diabetes mellitus (GDM) have an increased risk for the development of type 2 diabetes. Despite this "window of opportunity," few intervention studies have targeted postpartum women with a history of GDM. We sought perspectives of women with a history of GDM to identify a) barriers and facilitators to healthy lifestyle changes postpartum, and b) specific intervention approaches that would facilitate participation in a postpartum lifestyle intervention program. METHODS: We used mixed methods to gather data from women with a prior history of GDM, including focus groups and informant interviews. Analysis of focus groups relied on grounded theory and used open-coding to categorize data by themes, while frequency distributions were used for the informant interviews. RESULTS: Of 38 women eligible to participate in focus groups, only ten women were able to accommodate their schedules to attend a focus group and 15 completed informant interviews by phone. We analyzed data from 25 women (mean age 35, mean pre-pregnancy BMI 28, 52% Caucasian, 20% African American, 12% Asian, 8% American Indian, 8% refused to specify). Themes from the focus groups included concern about developing type 2 diabetes, barriers to changing diet, and barriers to increasing physical activity. In one focus group, women expressed frustration about feeling judged by their physicians during their GDM pregnancy. Cited barriers to lifestyle change were identified from both methods, and included time and financial constraints, childcare duties, lack of motivation, fatigue, and obstacles at work. Informants suggested facilitators for lifestyle change, including nutrition education, accountability, exercise partners/groups, access to gyms with childcare, and home exercise equipment. All focus group and informant interview participants reported access to the internet, and the majority expressed interest in an intervention program delivered primarily via the internet that would include the opportunity to work with a lifestyle coach. CONCLUSION: Time constraints were a major barrier. Our findings suggest that an internet-based lifestyle intervention program should be tested as a novel approach to prevent type 2 diabetes in postpartum women with a history of GDM.
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Remote monitoring and telemedicine-based approaches greatly improve care access for women with newborns.
“studies show that remote monitoring and telemedicine-based approaches greatly improve care access for women with newborns [116-118].”
From Wearables and the Medical Revolution (2018) · cites this paper as [118]
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Self-citation
- Authors
- Nicklas, J. M., Zera, C. A., Seely, E. W., Abdul-Rahim, Z. S., Rudloff, N. D., & Levkoff, S. E.
- Affiliations
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Nicklas, Jacinda M
- Venue
- BMC Pregnancy and Childbirth
- Published
- 2011-03-24
- Volume
- 11
- Issue
- 1
- Pages
- 23-23
- ISSN
- 1471-2393 (ISSN-L)
- PMC
- PMC3076295
- OpenAlex
- W2121003898
- Cited by
- 177
- References
- 34
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 14 · 2023: 14 · 2022: 10 · 2021: 13 · 2020: 20 · 2019: 13 · 2018: 14 · 2017: 12 · 2016: 14 · 2015: 13 · 2014: 16 · 2013: 6 · 2012: 8
- FWCI
- 12.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Pregnancy and Childbirth (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institutes of Health
- Centers for Disease Control and Prevention (CD05-050)
- National Heart, Lung, and Blood Institute (K24HL096141)
- National Center for Complementary and Alternative Medicine
- National Center for Complementary and Integrative Health (T32AT000051)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- gestational diabetes mellitus, type 2 diabetes prevention, postpartum women, lifestyle intervention, barriers to lifestyle change, online intervention, nutrition education, physical activity, time constraints, physician judgment, women's perspectives
- MeSH terms
- Adult, Diabetes Mellitus, Type 2, Diet, Female, Humans, Interviews as Topic, Health Knowledge, Attitudes, Practice, Life Style, Pregnancy, Risk Factors, Social Support, Exercise, Diabetes, Gestational, Focus Groups, Internet, Postpartum Period
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