Women’s views on the potential role of mobile technology in a primary care intervention aimed at reducing the risk of Type 2 diabetes amongst women recently diagnosed with Gestational Diabetes.

Conference:

SAPC ASM 2017 - Warwick

Talk Code:

1A.3

Presenter:

Caroline Mitchell

Co-authors:

Brian McMillan, Brigitte Delaney, Priya Madhuvrata, Katherine Easton, Reem Abdelgalil, Caroline Mitchell

Author institutions:

University of Manchester, University of Sheffield

Problem

Women who have had Gestational Diabetes (GD) are over 7 times more likely to develop diabetes mellitus (T2DM) than women with a normo-glycaemic pregnancy. Primary care postnatally is unsatisfactory, with reported annual rates of follow up of around 20%. The majority of behaviour change interventions (BCIs) aimed at reducing the risk of T2DM amongst women with a previous diagnosis of GD have been resource-intensive and not amenable to the primary care setting. Women in the post-natal period require flexible, longer term approaches that accommodate family and work commitments, and mobile technology may have potential to support this. A theoretically informed BCI utilising mobile technology in order to enable a sustained lifestyle change in women diagnosed with GD is urgently needed in the UK. This qualitative study aimed to inform the development of such an intervention.

Approach

Semi-structured interviews were conducted whilst women were waiting for their oral Glucose Tolerance Test at the hospital. The interview schedule included questions relating to: impact of diagnosis, what would happen postnatally, health implications of diagnosis, facilitators/barriers to exercise, diet, and weight loss, support received, use of technology (online, mobile, wearable), and suggestions for additional support postnatally. Field notes were taken after each recorded interview. Interviews were transcribed verbatim and transcriptions checked for accuracy and data familiarisation. QSR NVivo v11 software used to organise transcribed data and field notes. A thematic data analysis was conducted.

Findings

Twenty-seven women aged 21-44 years (mean=33, SD=6) were recruited from a range of ethnic and socioeconomic groups. Average age of leaving education was 20 yrs (16-26, SD=2.9). Four women had GD previously and 15 had a family history of T2DM. Two women reported being smokers and the average BMI was 30.0 (18-48, SD=7.7). There were a wide range of views on the potential role for mobile technology in a primary care intervention aimed at reducing the risk of Type 2 diabetes. Whilst some women were enthusiastic proponents of mobile technology, others expressed concerns with issues regarding quality, reliability, expense and the perception that wearables may be novelty items. Mobile technology was however thought to have potential as a time saving tool and as complimenting rather than a replacing face to face contact with health professionals.

Consequences

Postnatally, competing demands were a major reason for abandoning the positive lifestyle changes women made during pregnancy. Mobile technology may play a key role in interventions aimed at reducing the risk of T2DM by enabling a more efficient use of this time. There is a need however to address concerns regarding quality and reliability, and to examine in more depth how mobile technology can be effectively used to compliment face to face contact form healthcare professionals.

Submitted by:

Brian McMillan

Funding acknowledgement:

This work was funded by the Royal College of General Practitioners Scientific Foundation Board Grant (SFB2015-04). Brian McMillan completed this work while working as a National Institute for Health Research Academic Clinical Fellow in Primary Care at the University of Sheffield. Reem Abdelgalil was funded by an INSPIRE Studentship from the Academy of Medical Sciences.