MacKay, Diana

Maple-Brown, Louise

Freeman, Natasha

Boyle, Jacqueline A

Campbell, Sandra

McLean, Anna

Corpus, Sumaria

Whitbread, Cherie

Dokkum, Paula Van

Connors, Christine

Moore, Elizabeth

Sinha, Ashim

Cadet-James, Yvonne

Boffa, John

Graham, Sian

Oats, Jeremy

Brown, Alex

McIntyre, H David

Kirkham, Renae

2024-08-28

The Northern Territory (NT) and Far North Queensland (FNQ) have a high proportion of Aboriginal and Torres Strait Islander women birthing who experience hyperglycaemia in pregnancy. A multi-component health systems intervention to improve antenatal and postpartum care in these regions for women with hyperglycaemia in pregnancy was implemented between 2016 and 2019. We explored health professional perspectives on the impact of the intervention on healthcare. The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) underpinned this mixed-methods evaluation. Clinicians were surveyed before ( = 183) and following ( = 137) implementation. The constructs explored included usual practice and satisfaction with care pathways and communication between services. Clinicians, policymakers and the implementation team were interviewed ( = 36), exploring the impact of the health systems intervention on practice and systems of care. Survey and interview participants reported improvements in clinical practice and systems of care. Self-reported glucose screening practices improved, including the use of recommended tests (72.0% using recommended first-trimester screening test at baseline, 94.8% post-intervention, < 0.001) and the timing of postpartum diabetes screening (28.3% screening at appropriate interval after gestational diabetes at baseline, 66.7% post-intervention, < 0.001). Health professionals reported multiple improvements to care for women with hyperglycaemia in pregnancy following the health systems intervention.

Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia.

Department of Endocrinology, Royal Darwin Hospital, Darwin 0810, Australia.

Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia.

Department of Endocrinology, Royal Darwin Hospital, Darwin 0810, Australia.

Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia.

Eastern Health Clinical School, Monash University, Melbourne 3128, Australia.

Jawun Research Centre, Central Queensland University, Cairns 4870, Australia.

Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia.

Department of Diabetes and Endocrinology, Cairns and Hinterland Hospital and Health Service, Cairns 4870, Australia.

Department of Diabetes, Royal Darwin Hospital, Darwin 0810, Australia.

Danila Dilba Health Service, Darwin 0800, Australia.

Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia.

Department of Diabetes, Royal Darwin Hospital, Darwin 0810, Australia.

Alice Springs Hospital, Alice Springs 0870, Australia.

Northern Territory Department of Health, Darwin 0800, Australia.

Aboriginal Medical Services Alliance Northern Territory, Darwin 0800, Australia.

Department of Diabetes and Endocrinology, Cairns and Hinterland Hospital and Health Service, Cairns 4870, Australia.

Apunipima Cape York Health Council, Bungalow 4870, Australia.

Central Australian Aboriginal Congress, Alice Springs 0800, Australia.

Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia.

Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3053, Australia.

College of Health and Medicine, Australian National University, Canberra 2601, Australia.

Telethon Kids Institute, Perth 6009, Australia.

Mater Research, The University of Queensland, Brisbane 4101, Australia.

Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia.

Int J Environ Res Public Health . 2024 Aug 28;21(9):1139. doi: 10.3390/ijerph21091139.

1660-4601

0000-0002-3616-1637

0000-0002-4283-8499

0000-0001-8819-5794

https://pubmed.ncbi.nlm.nih.gov/39338022/?otool=iaurydwlib

https://hdl.handle.net/10137/13670

Aboriginal health

First Nations

diabetes in pregnancy

gestational diabetes

health systems

mixed methods

quality improvement

Humans

Female

Pregnancy

Hyperglycemia

Queensland

Adult

Prenatal Care

Native Hawaiian or Other Pacific Islander

Northern Territory

Health Personnel

Pregnancy Complications

Empowerment

"It Empowers You to Empower Them": Health Professional Perspectives of Care for Hyperglycaemia in Pregnancy Following a Multi-Component Health Systems Intervention.

Journal Article

Publication