Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado.
Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado.
Diabetes Educ. 2020 Jun;46(3):279-288. doi: 10.1177/0145721720920252.
The purpose of this study was to understand barriers and facilitators to engagement in a diabetes prevention program for young women at an urban safety-net health care system.
Individual semistructured interviews (N = 29) explored motivations, challenges, and successes regarding participation and suggestions for improvement among women aged 18 to 39 years who enrolled in the National Diabetes Prevention Program in the past 2 years. Participants were classified as nonattendees (n = 10), early-withdrawers (n = 9), or completers (n = 10). Interview transcriptions were analyzed using a grounded hermeneutic editing approach.
Qualitative analysis revealed 4 main themes (enrollment, attendance, experience, and suggestions) with multiple subthemes. Most women were motivated to enroll for health and family concerns. Early-withdrawers and nonattendees reported confusion about the program's aim and relevancy, logistical barriers, and lack of connection with fellow participants/coaches. Highly engaged women noted persistent motivation, perceived weight loss, and supportive program relationships.
Multiple barriers/facilitators for young women appear addressable in future adaptations. Additional research is needed to confirm these findings in other settings and explore implementation and effectiveness of adaptations, with a goal of reducing risks prior to conception.
本研究旨在了解城市医疗保障体系中青年女性参与糖尿病预防计划的障碍和促进因素。
对过去 2 年内参加国家糖尿病预防计划的 18 至 39 岁女性进行个人半结构化访谈（N=29），以了解其参与动机、挑战和成功经验，以及改进建议。参与者分为未参与者（n=10）、早期退出者（n=9）和完成者（n=10）。采用扎根解释学编辑方法对访谈记录进行分析。
定性分析揭示了 4 个主要主题（参与、出席、体验和建议），并包含多个子主题。大多数女性出于健康和家庭考虑而有参与动机。早期退出者和未参与者表示对该计划的目的和相关性感到困惑，存在后勤障碍，并且与其他参与者/教练缺乏联系。高度参与的女性则表示持续的动力、体重减轻的感知以及对项目关系的支持。
针对年轻女性的多种障碍/促进因素似乎可以在未来的调整中得到解决。需要在其他环境中进一步研究以证实这些发现，并探讨调整的实施和有效性，目标是在怀孕前降低风险。
