Table 5 Enablers and barriers for women with GDM understanding what effects their CBG concentrations
Domains and Definitions | Enablers | Barriers |
|---|---|---|
Knowledge Refers to a woman’s understanding of what affects her CBG concentrations | - understanding the difference between carbohydrates, proteins, and fats - ability to read and comprehend food labels - able to understand how physical activity or inactivity affects their CBG concentrations | - lack of understanding which foods and exercises raise the CBG concentrations - not knowing how to read food labels - knowing how to increase insulin to eat favourite sweets |
Belief about consequences Refers to a woman’s expectations about what affects her CBG concentration | - eating the same food every day for optimal glycaemic control - using commercially available, pre-assembled ready for cooking, health food bags for optimal glycaemic control - hearing other women’s stories encourages anticipated regret - regular activities easy to incorporate into daily life and ensures healthy baby | - belief only medication controls CBG concentrations - belief that exercises have no effect on CBG concentrations - belief that physical activity can cause pre-term labour |
Environmental context and resources Refers to a woman’s access to food, exercise equipment and health professionals | - access to dietitian and group sessions - food diary and discussion - food costs are less (no fast foods) - vegetable garden - recipes on social media - identifying food in pantry which are suitable with stickers - being organised - appropriate food available when not at home - access to exercise equipment (home bicycle, tread mill) - family and children creating motivating resources | - dietetic service unavailable - transport and time issues - not documenting a food diary or not knowing about it - health professionals do not discuss content of food diary - food is more expensive (fruit, special bread) - no ethnic food options included - unavailable professional assessment for exercise/physical activities - easy access to sugary food and drinks |
Emotions Refers to a woman’s reaction/feelings to what affects her CBG concentrations | - excited to understand the link between food and exercise and CBG concentrations | - stressed about trying hard but not able to achieve optimal CBG concentrations - feeling hungry most of the time |
Behavioural regulation Refers to a woman’s focus on self-monitoring effective food intake and exercise and planning how to incorporate this into daily life | - self-monitoring with food diary - developing an activity diary - calling exercise physical activity - calling diet food intake, or what to eat - action plan for physical activities - creatively incorporating family exercises affecting CBG concentrations - family and children creating motivating resources together | - dislike of exercises - medication and food is enough to maintain CBG levels - stress or excitement increases CBG concentrations, too hard to control |