학술논문
Respecting tribal voices in the development of a gestational diabetes risk reduction preconception counseling program for American Indian/Alaska Native adolescent females: a qualitative study.
Document Type
Article
Author
Moore, Kelly R.; Stotz, Sarah A.; Terry, Martha Ann; Seely, Ellen W.; Gonzales, Kelly; Marshall, Gale; Nadeau, Kristen J.; Akers, Aletha; Garcia-Reyes, Yesenia; Charron-Prochownik, Denise; Brega, Angela; Chalmers, Laura; Fischl, Andrea; Garrow, Heather; Howe, Jean; McNealy, Kristie; O'Banion, Nancy; Powell, Jeff; Sereika, Susan; Stein, Howard
Source
Subject
*PRECONCEPTION care
*GESTATIONAL diabetes
*ALASKA Natives
*TEENAGE girls
*MEDICAL personnel
*TEENAGE pregnancy
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Language
ISSN
1471-2393
Abstract
Background: American Indians and Alaska Natives (AI/AN) are disproportionately affected by adolescent obesity, adolescent pregnancy and gestational diabetes mellitus (GDM). GDM is associated with increased risk for perinatal death, obesity, and subsequent type 2 diabetes (T2D) for the offspring. Moreover, mothers with GDM are also at increased risk for T2D post-partum. Yet few lifestyle interventions exist to reduce GDM risk prior to pregnancy. We describe the process of adapting an existing validated preconception counseling intervention for AI/AN adolescent girls at-risk for GDM and their mothers. Perspectives and recommendations were gathered from a diverse array of stakeholders to assure the new program called Stopping GDM was culturally responsive and developed with tribal voices and perspectives represented. Methods: We conducted focus groups and individual interviews with multiple AI/AN stakeholders (n = 55). Focus groups and interviews were digitally recorded, transcribed verbatim, and analyzed using a thematic content approach to construct cross-cutting themes across the focus groups and interviews. Results: Four key themes emerged reflecting issues important to planning a reproductive health intervention: 1) Limited awareness, knowledge, and health education resources about GDM; 2) The importance of acknowledging traditional AI/AN values and the diversity of traditions and culture among AI/AN tribes; 3) The need to cultivate healthy decision-making skills and empower girls to make safe and healthy choices; and 4) Lack of communication about reproductive health between AI/AN mothers and daughters and between AI/AN women and health care professionals. Conclusion: Findings have been used to inform the cultural tailoring and adaptation of an existing preconception counseling program, originally designed for non-AI/AN adolescent girls with diabetes, for AI/AN adolescents at-risk for GDM in future pregnancies. [ABSTRACT FROM AUTHOR]