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Table 7 Considerations for practice and research

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

Practice considerations Research considerations
Monitoring for optimal glycaemic control Monitoring for optimal glycaemic control
• Enable women with GDM to attend group teaching for CBG testing and interpretation and include women who have had GDM to share their stories.
• Discuss individual strategies for regular CBG monitoring, food intake and physical activity.
• Encourage partner and family attendance at any clinic or teaching sessions (may need to be offered at evenings or weekends).
• Provide information relating to GDM in a woman’s first language and/or more visually, including ethnic food suggestions.
• Investigate the possibility of community pharmacists’ involvement in teaching CBG testing.
• Explore opportunities for companies to create phone Apps, e.g. for electronic food and activity diaries, recording of CBG results and medication intake.
• Do phone apps have an impact on optimal glycaemic control for women with GDM?
• Does a name change for GDM reduce anxiety in pregnant women?
Dietary intake and exercise for glycaemic control Dietary intake and exercise for glycaemic control
• Enable easy access to a diabetes dietitian with diet recommendations tailored to an individual woman’s context (cultural, financial, and emotional).
• Engage in meaningful discussions about the content in a food diary and provide multi-modal opportunity for the woman to record the food diary in her first language or enable mobile phone photo collection of food intake.
• Regularly address hunger for women with GDM.
• Encourage a physical activity diary alongside the food diary.
• Consider engaging a physical (activity) therapist for clear in-depth assessment and guidance of exercise that women can incorporate into their daily life.
• Does keeping a physical activity diary impact on glycaemic control?
• Does engaging a physical activity therapist contributes to the understanding and up-take of physical activity for women with GDM?
• Why do women with GDM seem to be hungry despite quality dietary recommendations?
• What affect has self-imposed dietary practices by women with GDM during their pregnancy on long term lifestyle behaviour?
Support for optimal glycaemic control Support for optimal glycaemic control
• Provide free CBG monitoring equipment, health shuttles and child care when attending clinic appointments and reduce clinic waiting times.
• Consider face-to-face support groups for women with GDM.
• Consider setting up a social media group for women. With current GDM (e.g. Facebook).
• Include regular mental health assessment for women with GDM.
• Provide direct phone access to multi-disciplinary health professionals.
• Limited research available for regular mental health assessment for women with GDM.
• Limited research about the effect of a GDM diagnosis on partners and family members.
• Limited research on how partners and families can best support a woman with GDM in their context.
• Does social media or face-face group support make a difference for women with GDM for maintaining optimal glycaemic control?