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

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

Paths to improving postpartum care in Aboriginal Australian and Torres Strait Islander women after gestational diabetes

What was this research project about? We aimed to understand why there are low rates of postpartum screening after gestational diabetes (GDM) among Aboriginal and Torres Strait Islander women, and what might help to improve this. 1. We interviewed seven (7) women who had gestational diabetes to understand barriers and enablers to postpartum screening. 2. Twenty (20) Aboriginal and Torres Strait Islander health workers came to focus groups to identify strategies to improve postpartum care. 3. Twenty-four (24) other service providers (doctors, nurses, midwives) attended workshops to discuss strategies and how to implement them