Table 1 Example moderator guide questions for each group of interviewees

Tribal and urban Indian health administrators and elected tribal leaders

1. Are you familiar with gestational diabetes or GDM?

2. Are there effective/successful programs in your community that address sexual health/sex education with AI/AN teen girls? Mothers? If so, what makes them effective/successful?

3. Are there effective/successful programs in your community that address diabetes prevention?

4. What do you know about teens in your community that would help us to modify this intervention to help them understand the importance of managing healthy lifestyles to prevent GDM?

5. What do you know about your tribal culture that would help us as we modify this intervention to make it more culturally relevant? How should it be included?

6. Tell me about any “coming-of-age” rituals which are practiced in your community

Expert panel of health care professionals

1. Please tell me your name and how you interact with AI/AN teens

2. How comfortable do you think the teen girls you know will be getting this kind of information? From whom? Will they be comfortable discussing it with those folks? With their friends? Their family?

3. What other sexual health and sexuality education programs do you know about that are successful with and respected by AI/AN girls and their moms?

4. What else can you tell us that you think will help us develop these materials into something that AI/AN teen girls will like, look at, talk about?

AI/AN girls (12–20 years of age) at risk for GDM and AI/AN adult female caregivers

1. How can a woman stay healthy during her pregnancy?

2. How does weight effect a pregnancy?

3. What do you know about gestational diabetes?

4. What do you know about preconception counseling?

5. What do you know about your tribal culture that would help us as we modify this intervention to make it more culturally appropriate for/acceptable to you and other girls like you? How should it be included?

6. If you had questions about gestational diabetes, pregnancy, puberty, birth control, who in your community would you ask? Where would you go to get this information?

AI/AN women with history of GDM

1. How can a woman stay healthy during her pregnancy?

2. How does weight affect a pregnancy?

3. What did you know about gestational diabetes before you had it?

4. What would you have liked to have known about gestational diabetes?

5. Where did you find information about GDM? What is helpful/useful?

6. What was good about the information you had and what wasn’t?

7. Do you think women with gestational diabetes are adequately educated/supported? If so, what is available to them? If not, what would be helpful to be available to them?

8. What do you know about preconception counseling?

9. What do you know about your tribal culture that would help us as we modify this intervention to make it more culturally appropriate for/acceptable to young women/teenagers in your community? How should it be included?

10. If a woman in your community had questions about gestational diabetes, pregnancy, puberty, birth control, where could she go and who could she ask? How could she get this information?

11. Do you feel that gestational diabetes can be prevented? If so, tell me about how you think it could be prevented