Nationwide Children's Hospital, Columbus, Ohio (Ms Ingol).
College of Nursing, The Ohio State University, Columbus, Ohio (Dr Kue).
Diabetes Educ. 2020 Jun;46(3):271-278. doi: 10.1177/0145721720920255.
The purpose of this qualitative study was to examine perceived barriers to adoption of lifestyle changes for type 2 diabetes prevention among a diverse group of low-income women with a history of gestational diabetes mellitus (GDM).
A secondary data analysis of 10 semistructured focus group discussions was conducted. Participants were low-income African American, Hispanic, and Appalachian women ages 18 to 45 years who were diagnosed with GDM in the past 10 years. A qualitative content analysis was conducted to identify key themes that emerged within and between groups.
Four key themes emerged on the role of knowledge, affordability, accessibility, and social support in type 2 diabetes prevention. Women discussed a lack of awareness of the benefits of breastfeeding and type 2 diabetes prevention, inaccessibility of resources in their local communities to help them engage in lifestyle change, and the desire for more culturally relevant education on healthful food options and proper portion sizes.
Study findings suggests that to improve effectiveness of type 2 diabetes prevention efforts among low-income women with GDM history, health care providers and public health practitioners should avoid using "one-size-fits-all" approaches to lifestyle change and instead use tailored interventions that address the cultural and environmental factors that impact women's ability to engage in recommended behavior change.
本定性研究旨在探讨不同种族的低收入、曾患有妊娠糖尿病（GDM）的女性对采用生活方式改变来预防 2 型糖尿病的看法，分析其对生活方式改变的认知障碍。
采用二次数据分析了 10 次半结构化焦点小组讨论。参与者为年龄在 18 至 45 岁之间的低收入非裔美国女性、西班牙裔女性和阿巴拉契亚女性，她们在过去 10 年中被诊断患有 GDM。采用定性内容分析法识别组内和组间出现的关键主题。
有四个关键主题出现在知识、可负担性、可及性和社会支持在 2 型糖尿病预防中的作用。女性讨论了对母乳喂养和 2 型糖尿病预防益处的缺乏认识、当地社区缺乏帮助她们进行生活方式改变的资源，以及对更具文化相关性的健康食品选择和适当份量教育的渴望。
研究结果表明，为了提高有 GDM 病史的低收入女性预防 2 型糖尿病的有效性，医疗保健提供者和公共卫生从业者应避免采用“一刀切”的生活方式改变方法，而应采用针对影响女性参与推荐行为改变能力的文化和环境因素的针对性干预措施。
