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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]