Feasibility of a Lifestyle Intervention Program for Prevention of Diabetes Among Women With Prior Gestational Diabetes Mellitus (LIVING Study) in South Asia: A Formative Research Study

Aim: To refine and contextually adapt a postpartum lifestyle intervention for prevention of type 2 diabetes mellitus (T2DM) in women with prior gestational diabetes mellitus (GDM) in Bangladesh, India, and Sri Lanka.Materials and Methods: In-depth interviews (IDIs) and focus group discussions (FGDs)...

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Main Authors: Abha Tewari, Devarsetty Praveen, Pavitra Madhira, Lakshmi K. Josyula, Rohina Joshi, Suresh B. Kokku, Vandana Garg, Ishita Rawal, Kanika Chopra, Nantu Chakma, Sabrina Ahmed, Arunasalam Pathmeswaran, Pavithra Godamunne, A. S. Lata, Rakesh Sahay, Tulsi Patel, Yashdeep Gupta, Nikhil Tandon, Aliya Naheed, Anushka Patel, Deksha Kapoor
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-11-01
Series:Frontiers in Global Women's Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fgwh.2020.587607/full
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language English
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author Abha Tewari
Devarsetty Praveen
Devarsetty Praveen
Devarsetty Praveen
Pavitra Madhira
Lakshmi K. Josyula
Lakshmi K. Josyula
Lakshmi K. Josyula
Rohina Joshi
Rohina Joshi
Suresh B. Kokku
Vandana Garg
Ishita Rawal
Kanika Chopra
Nantu Chakma
Sabrina Ahmed
Sabrina Ahmed
Arunasalam Pathmeswaran
Pavithra Godamunne
A. S. Lata
Rakesh Sahay
Tulsi Patel
Yashdeep Gupta
Nikhil Tandon
Aliya Naheed
Anushka Patel
Deksha Kapoor
spellingShingle Abha Tewari
Devarsetty Praveen
Devarsetty Praveen
Devarsetty Praveen
Pavitra Madhira
Lakshmi K. Josyula
Lakshmi K. Josyula
Lakshmi K. Josyula
Rohina Joshi
Rohina Joshi
Suresh B. Kokku
Vandana Garg
Ishita Rawal
Kanika Chopra
Nantu Chakma
Sabrina Ahmed
Sabrina Ahmed
Arunasalam Pathmeswaran
Pavithra Godamunne
A. S. Lata
Rakesh Sahay
Tulsi Patel
Yashdeep Gupta
Nikhil Tandon
Aliya Naheed
Anushka Patel
Deksha Kapoor
Feasibility of a Lifestyle Intervention Program for Prevention of Diabetes Among Women With Prior Gestational Diabetes Mellitus (LIVING Study) in South Asia: A Formative Research Study
Frontiers in Global Women's Health
South Asia
gestational diabetes
lifestyle intervention
health worker
barriers and facilitators
prevention of type 2 diabetes mellitus
author_facet Abha Tewari
Devarsetty Praveen
Devarsetty Praveen
Devarsetty Praveen
Pavitra Madhira
Lakshmi K. Josyula
Lakshmi K. Josyula
Lakshmi K. Josyula
Rohina Joshi
Rohina Joshi
Suresh B. Kokku
Vandana Garg
Ishita Rawal
Kanika Chopra
Nantu Chakma
Sabrina Ahmed
Sabrina Ahmed
Arunasalam Pathmeswaran
Pavithra Godamunne
A. S. Lata
Rakesh Sahay
Tulsi Patel
Yashdeep Gupta
Nikhil Tandon
Aliya Naheed
Anushka Patel
Deksha Kapoor
author_sort Abha Tewari
title Feasibility of a Lifestyle Intervention Program for Prevention of Diabetes Among Women With Prior Gestational Diabetes Mellitus (LIVING Study) in South Asia: A Formative Research Study
title_short Feasibility of a Lifestyle Intervention Program for Prevention of Diabetes Among Women With Prior Gestational Diabetes Mellitus (LIVING Study) in South Asia: A Formative Research Study
title_full Feasibility of a Lifestyle Intervention Program for Prevention of Diabetes Among Women With Prior Gestational Diabetes Mellitus (LIVING Study) in South Asia: A Formative Research Study
title_fullStr Feasibility of a Lifestyle Intervention Program for Prevention of Diabetes Among Women With Prior Gestational Diabetes Mellitus (LIVING Study) in South Asia: A Formative Research Study
title_full_unstemmed Feasibility of a Lifestyle Intervention Program for Prevention of Diabetes Among Women With Prior Gestational Diabetes Mellitus (LIVING Study) in South Asia: A Formative Research Study
title_sort feasibility of a lifestyle intervention program for prevention of diabetes among women with prior gestational diabetes mellitus (living study) in south asia: a formative research study
publisher Frontiers Media S.A.
series Frontiers in Global Women's Health
issn 2673-5059
publishDate 2020-11-01
description Aim: To refine and contextually adapt a postpartum lifestyle intervention for prevention of type 2 diabetes mellitus (T2DM) in women with prior gestational diabetes mellitus (GDM) in Bangladesh, India, and Sri Lanka.Materials and Methods: In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with women with current diagnosis of GDM, and health care professionals involved in their management, to understand relevant local contextual factors for intervention optimization and implementation. This paper describes facilitators and barriers as well as feedback from participants on how to improve the proposed intervention. These factors were grouped and interpreted along the axes of the three main determinants of behavior–capability, opportunity, and motivation. IDIs and FGDs were digitally recorded, transcribed, and translated. Data-driven inductive thematic analysis was undertaken to identify and analyze patterns and themes.Results: Two interrelated themes emerged from the IDIs and FGDs: (i) The lifestyle intervention was acceptable and considered to have the potential to improve the existing model of care for women with GDM; and (ii) Certain barriers such as reduced priority of self-care, and adverse societal influences postpartum need to be addressed for the improvement of GDM care. Based on the feedback, the intervention was optimized by including messages for family members in the content of the intervention, providing options for both text and voice messages as reminders, and finalizing the format of the intervention session delivery.Conclusion: This study highlights the importance of contextual factors in influencing postpartum care and support for women diagnosed with GDM in three South Asian countries. It indicates that although provision of postpartum care is complex, a group lifestyle intervention program is highly acceptable to women with GDM, as well as to health care professionals, at urban hospitals.
topic South Asia
gestational diabetes
lifestyle intervention
health worker
barriers and facilitators
prevention of type 2 diabetes mellitus
url https://www.frontiersin.org/articles/10.3389/fgwh.2020.587607/full
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spelling doaj-111a81de70a1458b87059a89ecc5faba2021-04-02T20:25:24ZengFrontiers Media S.A.Frontiers in Global Women's Health2673-50592020-11-01110.3389/fgwh.2020.587607587607Feasibility of a Lifestyle Intervention Program for Prevention of Diabetes Among Women With Prior Gestational Diabetes Mellitus (LIVING Study) in South Asia: A Formative Research StudyAbha Tewari0Devarsetty Praveen1Devarsetty Praveen2Devarsetty Praveen3Pavitra Madhira4Lakshmi K. Josyula5Lakshmi K. Josyula6Lakshmi K. Josyula7Rohina Joshi8Rohina Joshi9Suresh B. Kokku10Vandana Garg11Ishita Rawal12Kanika Chopra13Nantu Chakma14Sabrina Ahmed15Sabrina Ahmed16Arunasalam Pathmeswaran17Pavithra Godamunne18A. S. Lata19Rakesh Sahay20Tulsi Patel21Yashdeep Gupta22Nikhil Tandon23Aliya Naheed24Anushka Patel25Deksha Kapoor26George Institute for Global Health, New Delhi, IndiaGeorge Institute for Global Health, New Delhi, IndiaUniversity of New South Wales, Sydney, NSW, AustraliaPrasanna School of Public Health, Manipal Academy of Higher Education, Manipal, IndiaGeorge Institute for Global Health, New Delhi, IndiaGeorge Institute for Global Health, New Delhi, IndiaUniversity of New South Wales, Sydney, NSW, AustraliaPrasanna School of Public Health, Manipal Academy of Higher Education, Manipal, IndiaGeorge Institute for Global Health, New Delhi, IndiaThe George Institute for Global Health, University of New South Wales, Newtown, NSW, AustraliaGeorge Institute for Global Health, New Delhi, IndiaManav Rachna International Institute of Research and Studies (MRIIRS), Faridabad, IndiaCentre for Chronic Disease Control, New Delhi, IndiaAll India Institute of Medical Sciences, New Delhi, IndiaInternational Center for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, BangladeshInternational Center for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, BangladeshShiga University of Medical Science, Otsu, Japan0Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka0Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka1Sitaram Bhartia Institute of Science and Research, New Delhi, India2Department of Endocrinology, Osmania Medical College, Hyderabad, India3University of Delhi, New Delhi, IndiaAll India Institute of Medical Sciences, New Delhi, IndiaAll India Institute of Medical Sciences, New Delhi, IndiaInternational Center for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, BangladeshThe George Institute for Global Health, University of New South Wales, Newtown, NSW, AustraliaAll India Institute of Medical Sciences, New Delhi, IndiaAim: To refine and contextually adapt a postpartum lifestyle intervention for prevention of type 2 diabetes mellitus (T2DM) in women with prior gestational diabetes mellitus (GDM) in Bangladesh, India, and Sri Lanka.Materials and Methods: In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with women with current diagnosis of GDM, and health care professionals involved in their management, to understand relevant local contextual factors for intervention optimization and implementation. This paper describes facilitators and barriers as well as feedback from participants on how to improve the proposed intervention. These factors were grouped and interpreted along the axes of the three main determinants of behavior–capability, opportunity, and motivation. IDIs and FGDs were digitally recorded, transcribed, and translated. Data-driven inductive thematic analysis was undertaken to identify and analyze patterns and themes.Results: Two interrelated themes emerged from the IDIs and FGDs: (i) The lifestyle intervention was acceptable and considered to have the potential to improve the existing model of care for women with GDM; and (ii) Certain barriers such as reduced priority of self-care, and adverse societal influences postpartum need to be addressed for the improvement of GDM care. Based on the feedback, the intervention was optimized by including messages for family members in the content of the intervention, providing options for both text and voice messages as reminders, and finalizing the format of the intervention session delivery.Conclusion: This study highlights the importance of contextual factors in influencing postpartum care and support for women diagnosed with GDM in three South Asian countries. It indicates that although provision of postpartum care is complex, a group lifestyle intervention program is highly acceptable to women with GDM, as well as to health care professionals, at urban hospitals.https://www.frontiersin.org/articles/10.3389/fgwh.2020.587607/fullSouth Asiagestational diabeteslifestyle interventionhealth workerbarriers and facilitatorsprevention of type 2 diabetes mellitus