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Table 6 Enablers and barriers of support for women with GDM about maintaining optimal CBG control?

From: Enablers and barriers for women with gestational diabetes mellitus to achieve optimal glycaemic control – a qualitative study using the theoretical domains framework

Domains and Definitions Enablers Barriers
Beliefs about consequences
Refers to a woman’s expectation to sharing her diagnosis of GDM with others
- telling others about GDM diagnosis gains valuable support Not telling others about GDM diagnosis because:
- concern for other family members
- being judged by family, friends and work colleagues
- being told what and what not to eat
Reinforcement
Refers to a woman’s ability to reinforce skills and coping strategies for self-support in maintaining optimal glycaemic control
- continuing with food diary, feeling better
- photos of food eaten instead of written food dairy
- self-rewards with non-food items
- documenting CBG results
- activities connected with family fun
 
Environmental context and resources
Refers to a woman’s ability to have access to learning resources and professional services for optimal glycaemic control
- written information in first language
- visual information
- informative websites
- partner and extended family able to attend teaching or clinic sessions
- work colleagues enquiring and providing healthy food options
- efficient clinic appointment system
- health professional phone support
- free health shuttle for appointments
- hospital crèche
- stickers with healthy GDM messages encourages adherence to healthy food and exercises
- health professional impatient
- health professionals inconsistent with advice
- not seeing the same health professional twice
- long waiting times at clinic
- not taught in first language
- unable to write the food dairy in first language
- no visual information available
- website information random and scary
- poor parking facilities
- no transport available
- unable to pay for petrol
- no child care support
- restaurants unable provide an ingredients list for meals
- partner and extended family provide unhealthy meals
Social influences
Refers to a woman’s access to social interaction to learning/reinforcing optimal glycaemic control
- social media (Facebook)
- sharing recipes
- group teaching
- meeting other women with GDM
- partner, family, and friend’s interest
- work colleagues support
- unsupportive family members and workplaces
- no social media groups or support groups in NZ
- not knowing anyone with GDM
- unable to perform testing in public
- told what to eat by family members