Co-designing a family-centred hyperglycaemia in pregnancy self-management program with Aboriginal women  — ASN Events
  1. Schedule
  2. Session 3: Obesity in Pregnancy
  3. Co-designing a family-centred hyperglycaemia in pregnancy self-management program with Aboriginal women 

Co-designing a family-centred hyperglycaemia in pregnancy self-management program with Aboriginal women  (107626)

Maureen Pigram 1 , Erica Spry 1 2 , Michelle Thomas 3 , Matt Le Lievre 1 , Kylie Bowden 4 , Steve Pratt 1 , Emma Jamieson 3 , Julia Marley 1
  1. Rural Clinical School of Western Australia (RCSWA), Broome, WESTERN AUSTRALIA, Australia
  2. Kimberley Aboriginal Medical Services, Broome , WA, Australia
  3. Rural Clinical School of Western Australia (RCSWA), Bunbury , Western Australia, Australia
  4. Rural Clinical School of Western Australia (RCSWA), Albany, Western Australia, Australia

Background: Aboriginal Peoples have increased risk for hyperglycaemia in pregnancy (HIP) that increases risk for adverse birth outcomes and future diabetes in mother and child. Public health action to optimise screening for and management of HIP are required to improve outcomes.

Phase 1 of the large optimisation of screening and management of HIP (ORCHID) study, the prospective cohort in rural and remote WA (N =600) identified glycated haemoglobin as an acceptable screening test that can improve screening coverage and identify Aboriginal women with hyperglycaemia early in pregnancy (<20-weeks).1,2 Early screening for HIP using glycated haemoglobin was implemented by Kimberley Aboriginal Community Controlled Health Services (ACCHS) in 2017.

Aim: To use three-way learning between Aboriginal community members, clinicians, and researchers to co-design management strategies that focus on family support and Aboriginal women's capacity to self-manage hyperglycaemia from early in pregnancy.

Methods: Research yarns and semi-structured interviews with 47 participants (21 community; 26 clinicians) to identify barriers and enablers for self-management of HIP and assess acceptability of using technology. NVivo 14 was used to code transcripts. Aboriginal and non-Aboriginal researchers conducted thematic analysis.

Results: Preliminary coding and thematic analysis suggest:
1. Continuous glucose monitoring (CGM) technology is acceptable to Aboriginal mothers.
2. A lack of culturally appropriate resources.
3. Clinicians create tailored educational resources collated from multiple sources
4. Clinicians are time-poor when aiming to keep up to date with changes and technology.
5. Women attending ACCHS feel supported during pregnancy but experience disjointed care postpartum.
6. Women value quarantined time for ‘women’s business’ but are keen for support for fathers and family members.

Discussion: Findings from the yarns and interviews will inform the co-design and evaluation of a family-centred HIP self-management program incorporating CGM. In addition, the findings will inform the development or collation of culturally appropriate resources. When we support Aboriginal families, especially first-time parents, to better understand and self-manage HIP, we have the capacity to improve birth outcomes and reduce the intergenerational cycle of diabetes. It is also clear that there needs to be better postpartum follow-up to identify women with ongoing type 2 diabetes or prediabetes.

  1. Jamieson, E. L., Spry, E. P., Kirke, A. B., Griffiths, E., Porter, C., Roxburgh, C., Singleton, S., Sterry, K., Atkinson, D. & Marley, J. V. Real-world screening for diabetes in early pregnancy: improved screening uptake using universal glycated haemoglobin. Prim. Care Diabetes, doi:https://dx.doi.org/10.1016/j.pcd.2021.09.011 (2021).
  2. Jamieson, E. L., Spry, E. P., Kirke, A. B., Griffiths, E., Porter, C., Roxburgh, C., Singleton, S., Sterry, K., Atkinson, D. N. & Marley, J. V. Prediabetes and pregnancy: Early pregnancy HbA1c identifies Australian Aboriginal women with high-risk of gestational diabetes mellitus and adverse perinatal outcomes. Diabetes Res. Clin. Pract., 108868, doi:https://doi.org/10.1016/j.diabres.2021.108868 (2021).
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