Improving postpartum screening after diabetes in pregnancy: Results of a pilot study in remote Australia.
Diabetes, Gestational
/ diagnosis
Female
Health Services, Indigenous
/ standards
Humans
Mass Screening
Maternal Health Services
/ standards
Medically Underserved Area
Native Hawaiian or Other Pacific Islander
Northern Territory
Pilot Projects
Pregnancy
Prenatal Care
/ standards
Puerperal Disorders
/ diagnosis
Quality Improvement
Telemedicine
/ standards
aboriginal
diabetes
postpartum period
postpartum screening
text messaging
Journal
The Australian & New Zealand journal of obstetrics & gynaecology
ISSN: 1479-828X
Titre abrégé: Aust N Z J Obstet Gynaecol
Pays: Australia
ID NLM: 0001027
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
27
04
2018
accepted:
07
08
2018
pubmed:
3
10
2018
medline:
20
5
2020
entrez:
3
10
2018
Statut:
ppublish
Résumé
The postpartum period is a critical time to improve health outcomes for Aboriginal women, particularly for those who have chronic conditions. To assess enhanced support methods (for women following diabetes in pregnancy (DIP)) to improve completion rates of recommended postpartum health checks. Fifty-three Aboriginal women in the Northern Territory (NT) were contacted in the postpartum period to encourage medical check-ups. Messages were delivered through phone (call or text messages) or other methods (Facebook or email). The primary outcome was postpartum blood glucose testing (oral glucose tolerance testing (OGTT), random or fasting glucose and HbA1c). Establishing contact with women was difficult. Of 137 messages sent to 52 women, 22 responded (42%). Phone was the most common contact method with successful contact made from 16 of 119 (13%) attempts. Rates of postpartum OGTT completion were higher in the group successfully contacted (32% vs 7%). However, for any postpartum glucose testing (including OGTT and HbA1c) rates were 25 of 42 (60%) and neither success in making contact nor the contact method was associated with higher rates. The small sample size limits our conclusions; however, results highlight that engaging remote women postpartum is difficult. While rates of postpartum OGTT completion differed according to successful contacts, rates of any postpartum blood glucose testing did not. Further research is needed to explore feasible intervention methods to improve postpartum screening after a pregnancy complicated by diabetes.
Sections du résumé
BACKGROUND
The postpartum period is a critical time to improve health outcomes for Aboriginal women, particularly for those who have chronic conditions.
AIMS
To assess enhanced support methods (for women following diabetes in pregnancy (DIP)) to improve completion rates of recommended postpartum health checks.
MATERIALS AND METHODS
Fifty-three Aboriginal women in the Northern Territory (NT) were contacted in the postpartum period to encourage medical check-ups. Messages were delivered through phone (call or text messages) or other methods (Facebook or email). The primary outcome was postpartum blood glucose testing (oral glucose tolerance testing (OGTT), random or fasting glucose and HbA1c).
RESULTS
Establishing contact with women was difficult. Of 137 messages sent to 52 women, 22 responded (42%). Phone was the most common contact method with successful contact made from 16 of 119 (13%) attempts. Rates of postpartum OGTT completion were higher in the group successfully contacted (32% vs 7%). However, for any postpartum glucose testing (including OGTT and HbA1c) rates were 25 of 42 (60%) and neither success in making contact nor the contact method was associated with higher rates.
CONCLUSIONS
The small sample size limits our conclusions; however, results highlight that engaging remote women postpartum is difficult. While rates of postpartum OGTT completion differed according to successful contacts, rates of any postpartum blood glucose testing did not. Further research is needed to explore feasible intervention methods to improve postpartum screening after a pregnancy complicated by diabetes.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
430-435Subventions
Organisme : National Health and Medical Research Council
ID : 1092968
Pays : International
Organisme : National Health and Medical Research Council
ID : 1078477
Pays : International
Organisme : National Health and Medical Research Council
ID : 1079438
Pays : International
Informations de copyright
© 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.