Preventing Chronic Disease | Identifying Postpartum Intervention Approaches to Reduce Cardiometabolic Risk Among American Indian Women With Prior Gestational Diabetes, Oklahoma, 2012–2013 - CDC
Identifying Postpartum Intervention Approaches to Reduce Cardiometabolic Risk Among American Indian Women With Prior Gestational Diabetes, Oklahoma, 2012–2013
Emily J. Jones, PhD, RNC-OB; Michael Peercy, MPH, MT(ASCP)H; J. Cedric Woods, PhD; Stephany P. Parker, PhD; Teresa Jackson, MS, RD, LD; Sara A. Mata, PhD; Shondra McCage, MPH; Sue E. Levkoff, ScD, SM, MSW; Jacinda M. Nicklas, MD, MPH, MA; Ellen W. Seely, MD
Suggested citation for this article: Jones EJ, Peercy M, Woods JC, Parker SP, Jackson T, Mata SA, et al. Identifying Postpartum Intervention Approaches to Reduce Cardiometabolic Risk Among American Indian Women With Prior Gestational Diabetes, Oklahoma, 2012–2013. Prev Chronic Dis 2015;12:140566. DOI: http://dx.doi.org/10.5888/pcd12.140566
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Abstract
Introduction
Innovative approaches are needed to reduce cardiometabolic risk among American Indian women with a history of gestational diabetes. We assessed beliefs of Oklahoma American Indian women about preventing type 2 diabetes and cardiovascular disease after having gestational diabetes. We also assessed barriers and facilitators to healthy lifestyle changes postpartum and intervention approaches that facilitate participation in a postpartum lifestyle program.
Innovative approaches are needed to reduce cardiometabolic risk among American Indian women with a history of gestational diabetes. We assessed beliefs of Oklahoma American Indian women about preventing type 2 diabetes and cardiovascular disease after having gestational diabetes. We also assessed barriers and facilitators to healthy lifestyle changes postpartum and intervention approaches that facilitate participation in a postpartum lifestyle program.
Methods
In partnership with a tribal health system, we conducted a mixed-method study with American Indian women aged 19 to 45 years who had prior gestational diabetes, using questionnaires, focus groups, and individual interviews. Questionnaires were used to identify women’s cardiometabolic risk perceptions and feasibility and acceptability of Internet or mobile phone technology for delivery of a postpartum lifestyle modification program. Focus groups and individual interviews were conducted to identify key perspectives and preferences related to a potential program.
In partnership with a tribal health system, we conducted a mixed-method study with American Indian women aged 19 to 45 years who had prior gestational diabetes, using questionnaires, focus groups, and individual interviews. Questionnaires were used to identify women’s cardiometabolic risk perceptions and feasibility and acceptability of Internet or mobile phone technology for delivery of a postpartum lifestyle modification program. Focus groups and individual interviews were conducted to identify key perspectives and preferences related to a potential program.
Results
Participants were 26 women, all of whom completed surveys; 11 women participated in focus group sessions, and 15 participated in individual interviews. Most women believed they would inevitably develop diabetes, cardiovascular disease, or both; however, they were optimistic that they could delay onset with lifestyle change. Most women expressed enthusiasm for a family focused, technology-based intervention that emphasizes the importance of delaying disease onset, provides motivation, and promotes accountability while accommodating women’s competing priorities.
Participants were 26 women, all of whom completed surveys; 11 women participated in focus group sessions, and 15 participated in individual interviews. Most women believed they would inevitably develop diabetes, cardiovascular disease, or both; however, they were optimistic that they could delay onset with lifestyle change. Most women expressed enthusiasm for a family focused, technology-based intervention that emphasizes the importance of delaying disease onset, provides motivation, and promotes accountability while accommodating women’s competing priorities.
Conclusions
Our findings suggest that an intervention that uses the Internet, text messaging, or both and that emphasizes the benefits of delaying disease onset should be tested as a novel, culturally relevant approach to reducing rates of diabetes and cardiovascular disease in this high-risk population.
Our findings suggest that an intervention that uses the Internet, text messaging, or both and that emphasizes the benefits of delaying disease onset should be tested as a novel, culturally relevant approach to reducing rates of diabetes and cardiovascular disease in this high-risk population.
Acknowledgments
We thank all participants in the focus groups and individual interviews and the staff and providers in the CNDH who provided recruitment assistance in this study. Financial support for this research was provided by the University of Massachusetts Boston Proposal Development Award (2012–2013) and the Theta Alpha Chapter of Sigma Theta Tau International. Dr Jones is a 2014 Robert Wood Johnson Foundation Nurse Faculty Scholar and recognizes the Foundation’s support of this work. Dr Nicklas was supported by National Institute of Health grant no. 5K12HD057022-08, Building Interdisciplinary Research Careers in Women’s Health, and Dr Seely was supported by a K24 from the National Heart, Lung, and Blood Institute at the National Institutes of Health (no. K24HL096141). Drs Parker and Mata were supported by Oklahoma State University.
Author Information
Corresponding Author: Emily J. Jones, PhD, RNC-OB, College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125. Telephone: 617-287-5954. E-mail: emily.jones@umb.edu.
Author Affiliations: Michael Peercy, Teresa Jackson, Shondra McCage, Chickasaw Nation Department of Health, Ada, Oklahoma; J. Cedric Woods, Institute for New England Native American Studies, University of Massachusetts Boston, Massachusetts; Stephany P. Parker, Sara A. Mata, Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma; Sue E. Levkoff, College of Social Work, University of South Carolina, Columbia, South Carolina; Jacinda M. Nicklas, Division of General Internal Medicine, University of Colorado School of Medicine, Boulder, Colorado; Ellen W. Seely, Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital/Harvard Medical School, Boston, Massachusetts.
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