Please use this identifier to cite or link to this item: https://hdl.handle.net/10137/5235
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dc.contributor.authorKlein Jen
dc.contributor.authorBoyle JAen
dc.contributor.authorKirkham Ren
dc.contributor.authorConnors Cen
dc.contributor.authorWhitbread Cen
dc.contributor.authorOats Jen
dc.contributor.authorBarzi Fen
dc.contributor.authorMcIntyre Den
dc.contributor.authorLee Ien
dc.contributor.authorLuey Men
dc.contributor.authorShaw Jen
dc.contributor.authorBrown ADHen
dc.contributor.authorMaple-Brown LJen
dc.date2017en
dc.date.accessioned2018-05-15T23:00:32Zen
dc.date.available2018-05-15T23:00:32Zen
dc.date.issued2017-07en
dc.identifier.citationDiabetes research and clinical practice 2017-07; 129: 105-115en
dc.identifier.urihttps://hdl.handle.net/10137/5235en
dc.description.abstractPreconception care may decrease adverse pregnancy outcomes associated with pre-existing diabetes mellitus. Aboriginal Australians are at high risk of type 2 diabetes mellitus (T2DM), with earlier onset. We explored practitioner views on preconception care delivery for women with T2DM in the Northern Territory, where 31% of births are to Aboriginal women. Mixed-methods study including cross-sectional survey of 156 health practitioners and 11 semi-structured interviews. Practitioners reported low attendance for preconception care however, 51% provided counselling on an opportunistic basis. Rural/remote practitioners were most likely to find counselling feasible. The majority (69%) utilised appropriate guidelines and addressed lifestyle modifications including smoking (81%), weight management (79%), and change medications appropriately such as ceasing ACE inhibitors (69%). Fewer (40%) prescribed the recommended dose of folate (5mg) or felt comfortable recommending delaying pregnancy to achieve optimal preconception glucose control (42%). Themes identified as barriers to care included the complexity of care setting and infrequent preconception consultations. There was a focus on motivation of women to make informed choices about conception, including birth spacing, timing and contraception. Preconception care enablers included cross-cultural communication, a multi-disciplinary care team and strong client-based relationships. Health practitioners are keen to provide preconception counselling and reported knowledge of evidence-based guidelines. Improvements are needed in recommending high dose folate and optimising glucose control. Cross-cultural communication and team-based care were reported as fundamental to successful preconception care in women with T2DM. Continued education and policy changes are required to support practitioners in opportunities to enhance pregnancy planning.en
dc.language.isoengen
dc.subjectAboriginal healthen
dc.subjectDiabetes in pregnancyen
dc.subjectPreconception careen
dc.subjectType 2 diabetes mellitusen
dc.titlePreconception care for women with type 2 diabetes mellitus: A mixed-methods study of provider knowledge and practice.en
dc.typeJournal Articleen
dc.identifier.journaltitleDiabetes research and clinical practiceen
dc.identifier.doi10.1016/j.diabres.2017.03.035en
dc.identifier.pubmedidhttps://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed//28521194en
dc.subject.meshAdulten
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshDiabetes Mellitus, Type 2en
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshPreconception Careen
dc.subject.meshPregnancyen
dc.subject.meshPregnancy Complicationsen
dc.identifier.affiliationRoyal Darwin Hospital, Darwin, Australia; Department of Obstetrics and Gynaecology, Eastern Health, Melbourne, Australia..en
dc.identifier.affiliationMonash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Menzies School of Health Research, Darwin, Australia..en
dc.identifier.affiliationMenzies School of Health Research, Darwin, Australia..en
dc.identifier.affiliationNorthern Territory Department of Health, Darwin, Australia..en
dc.identifier.affiliationRoyal Darwin Hospital, Darwin, Australia; Menzies School of Health Research, Darwin, Australia..en
dc.identifier.affiliationMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia..en
dc.identifier.affiliationMenzies School of Health Research, Darwin, Australia..en
dc.identifier.affiliationMater Medical Research Institute, University of Queensland, Brisbane, Australia..en
dc.identifier.affiliationMenzies School of Health Research, Darwin, Australia..en
dc.identifier.affiliationCentral Australian Aboriginal Congress, Alice Springs, Australia..en
dc.identifier.affiliationBaker IDI Heart and Diabetes Institute, Melbourne, Australia..en
dc.identifier.affiliationSouth Australian Health and Medical Research Institute, Adelaide, Australia; University of South Australia, Adelaide, Australia..en
dc.identifier.affiliationRoyal Darwin Hospital, Darwin, Australia; Menzies School of Health Research, Darwin, Australia. Electronic address: louise.maple-brown@menzies.edu.au..en
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