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Table 4 Evaluation of interventions proposed for enhancement of Pre-Pregnancy Management (PPM) based on weighing pros and cons items

From: Development of an integrated, district-wide approach to pre-pregnancy management for women with pre-existing diabetes in a multi-ethnic population

Interventions Content/ details Places (to be implemented) Pros Cons Included
Workshops for HCPsa Interpersonal techniques for communicating with other HCPs and patients (including CALDb women), and PPMc Primary and secondary care services Motivational, Enhancing skills and knowledge Lack of flexibility in time, expensive Yes
DVD ‘Risk of unplanned pregnancy, and effective contraception methods’, ‘local support team’, ‘blood glucose targets, hypos and ketoacidosis’, ‘diet, delivery’ and ‘post-birth’ Primary and secondary care services including pharmacies Easily accessible and convenient High cost, not sustainable (can be lost/or scratched) No
Web-based education program PPM information, links to pre-existing YouTube channels in multiple languages e.g. Arabic and Vietnamese Websites and social media Easily accessible and convenient, no limits in content Passive Yes
Courses for patients and their partners The importance of PPM (e.g. glycaemic control, smoking cessation and physical activity) and use of effective contraception Primary and secondary care services, women’s health clinics Motivational, they can ask questions High cost, lack of flexibility in time No
Posters presentation /T.V screen advertisement The importance of PPM with information about available local services (contact details for local HCPs) Waiting rooms of primary and secondary care services, pharmacies, women’s health and fertility clinics Easily visible, encourage an active response Limited content Yes
Peer support/web chat Sharing experiences about diabetes in pregnancy and services they have used DCAPP social media Easily accessible and convenient Possibility of inaccuracy (Vulnerable to (cognitive) biases) Yes
Text message reminders Links to the important websites, available resources (e.g. local pre-pregnancy clinics, social media) Will be sent from the GP practices on regular bases (every six weeks) Easily accessible and convenient High cost No
Leaflets Links to useful websites, potential risks of unplanned pregnancy and risk factors for potential complications Primary and secondary care services, mail, pharmacies and women’s health clinics Easy to access High cost (if mailed), lack of interest (so common) Yes
Apps ‘Risk of unplanned pregnancy, and effective contraception methods’, ‘local support team’, ‘blood glucose targets, hypos and ketoacidosis’, ‘diet, delivery’ and ‘post-birth’ DCAPP website and social media, leaflets, and posters Systematic approach, no cost to design (already existed) Only available to smart-phone users Yes
Social media Useful websites (e.g. NDSSd), updates/posts on the importance of PPM and contraception, and YouTube channel Online (i.e. Facebook and Instagram) High chance of being visited regularly Only available to DCAPP social media followers Yes
Checklist software for general practitioners Medication review, contraception advice, weight management strategies, importance of having optimal glycaemic control GP surgeries Systematic approach High cost of design
Needs to articulate with existing software
No
  1. aHCPs: health care professionals
  2. bCALD: culturally and linguistically diverse
  3. cPPM: pre-pregnancy management
  4. dNDSS: National Diabetes Service Scheme: An initiative of the Australian Government administered with the assistance of Diabetes Australia [47]