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Sereika SM, Moore KR, Stotz S, Chalmers LJ, Garrow H, Gonzales K, O'Banion N, Powell J, Knoki-Wilson U, Charron-Prochownik D. The Associations Between Health-Related Knowledge and Health Beliefs Regarding Risk for Gestational Diabetes in American Indian and Alaska Native Female Adolescents and Young Adults at Risk for Gestational Diabetes and Their Female Caregivers: A Cross-Sectional Dyadic Analysis. J Midwifery Womens Health 2024; 69:383-393. [PMID: 38831486 DOI: 10.1111/jmwh.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/13/2024] [Indexed: 06/05/2024]
Abstract
INTRODUCTION Research on associations between knowledge and health beliefs for women at risk for gestational diabetes mellitus (GDM) has focused on adults at risk for or having GDM. Gaps also exist in examining interpersonal associations with family members or peers. We examined dyadic associations between knowledge and health beliefs about the risk for GDM between and within American Indian and Alaska Native (AIAN) female adolescents and young adults (FAYAs) at risk for GDM and their mothers or adult female caregivers (FCs). METHODS Grounded in the Expanded Health Belief Model, we employed a cross-sectional design using baseline data from 147 dyads of AIAN FAYAs at risk for GDM and their FCs who participated in the Stopping GDM in Daughters and Mothers trial. FAYAs were 12.0 to 24.5 years of age, and 89.1% were students. FCs had a mean (SD) age of 44.0 (9.3) years, 87.0% were AIAN, 44.9% were college educated, 19.7% had ever had GDM, and 81.0% were the FAYA's mother. FAYAs and FCs completed surveys about knowledge and health beliefs (benefits, barriers, severity, susceptibility) regarding GDM risk and prevention. Bivariate correlational analyses were performed to examine associations between and within dyad members. Dyadic associations were investigated using actor-partner interdependence modeling (APIM) assuming distinguishable dyad members. RESULTS Compared with their FCs, FAYAs had lower health-related knowledge and perceived benefits of GDM prevention and susceptibility regarding GDM risk. APIM revealed actor and partner effects of health-related knowledge on health beliefs for dyads. In particular, positive actor effects were found for FAYAs and FCs for GDM-related knowledge with perceived benefits (P < .001), and positive partner effects of GDM-related knowledge for FCs were related to perceived susceptibility and severity for FAYAs (P < .05). DISCUSSION As shown in these AIAN dyads, FAYAs and their FCs, as members of one another's social network, may influence each other's health beliefs regarding GDM risk and prevention.
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Affiliation(s)
- Susan M Sereika
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kelly R Moore
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Sarah Stotz
- Department of Food Science and Human Nutrition, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado
| | - Laura J Chalmers
- Department of Pediatrics, School of Medicine, University of Oklahoma, Tulsa, Oklahoma
| | | | - Kelly Gonzales
- School of Public Health, Oregon Health Science University-Portland State University, Portland, Oregon
| | - Nancy O'Banion
- Indian Health Care Resource Center of Tulsa, Tulsa, Oklahoma
| | - Jeffrey Powell
- Northern Navajo Medical Center, Navajo Area Indian Health Service, Shiprock, New Mexico
| | | | - Denise Charron-Prochownik
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
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Walker C, Begum T, Boyle JA, Ward J, Barzi F. Preconception Health of Indigenous Peoples in Australia, Canada, New Zealand, and the United States: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:345. [PMID: 38541344 PMCID: PMC10969840 DOI: 10.3390/ijerph21030345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/23/2024] [Accepted: 02/28/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND There is increasing recognition of the importance of the preconception period for addressing reproductive and intergenerational health inequities and supporting improved maternal and child health outcomes. This study aimed to understand the extent and type of evidence that exists in relation to preconception health for Indigenous peoples living in high-income countries with similar experiences of colonisation, namely, Australia, New Zealand, Canada, and the United States. METHODS This review was conducted as per the JBI methodology and PRISMA Extension for Scoping Reviews. A comprehensive search of PubMed, CINAHL [EBSCO], Ovid Embase, Scopus, and the Wiley Cochrane Library was conducted using keywords and index terms. We included research in English published between January 2010 and June 2023 on quantitative and qualitative primary studies. Data were extracted using a standardised tool, and the analysis included quantitative descriptions and qualitative content analysis. RESULTS We identified 360 potential studies and included 57 articles in the review. Most studies were from the United States (n = 36, 63.2%) and Australia (n = 13, 22.8%), and they commonly reported associations between preconception health risk factors and maternal or child health outcomes (n = 27, 48.2%) or described the development, implementation, or evaluation of preconception health interventions (n = 26, 46.4%). Common preconception health areas were pre-pregnancy body mass index or weight (n = 34), alcohol (n = 16), diet (n = 14), physical activity (n = 12), and diabetes (n = 11). Most studies focused exclusively on women (n = 46, 80.7%), and very few included men (n = 3, 5.3%). The study populations were mostly urban and rural (n = 25, 43.9%) or rural only (n = 14, 24.6%); however, the geographical remoteness was often unclear (n = 14, 24.6%). CONCLUSIONS While there was some research relating to the preconception health of Indigenous peoples, this review identified considerable research gaps. There is a need for dedicated research into preconception health risk factors and reproductive health outcomes, attitudes and awareness of preconception health, and preconception health interventions for Indigenous peoples.
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Affiliation(s)
- Clara Walker
- UQ Poche Centre for Indigenous Health, The University of Queensland, Toowong, QLD 4066, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia
| | - Tahmina Begum
- UQ Poche Centre for Indigenous Health, The University of Queensland, Toowong, QLD 4066, Australia
| | - Jacqueline A Boyle
- Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia
| | - James Ward
- UQ Poche Centre for Indigenous Health, The University of Queensland, Toowong, QLD 4066, Australia
| | - Federica Barzi
- UQ Poche Centre for Indigenous Health, The University of Queensland, Toowong, QLD 4066, Australia
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Hebert LE, Nikolaus CJ, Zamora-Kapoor A, Sinclair KA. Gestational Diabetes and Breastfeeding Among Women of Different Races/Ethnicities: Evidence from the Pregnancy Risk Assessment Monitoring Surveys. J Racial Ethn Health Disparities 2023; 10:1721-1734. [PMID: 35819722 PMCID: PMC10367934 DOI: 10.1007/s40615-022-01356-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To examine risk factors for gestational diabetes mellitus (GDM) and factors associated with breastfeeding patterns among women with GDM from different racial/ethnic groups. METHODS We used data from Phase 8 (2016-2018) of the Pregnancy Risk Assessment Monitoring System. We used logistic regression to estimate factors associated with GDM and with breastfeeding initiation, and conducted survival analysis using Kaplan-Meier curves, and Cox proportional hazards regression to analyze early cessation of breastfeeding. RESULTS Among American Indian and Alaska Native (AI/AN) women, higher education reduced odds (aOR = 0.33; 95% CI: 0.19-0.59) and being married increased odds (aOR = 1.35; 95% CI: 1.02-1.79) of GDM. AI/AN women who received WIC benefits had lower odds of initiating breastfeeding (aOR = 0.70; 95% CI: 0.51-0.95). While there was no association between GDM and initiation of breastfeeding, only a third of AI/AN women with GDM were still breastfeeding by 36 weeks postpartum, compared to more than half of non-Hispanic White and Hispanic women. CONCLUSIONS FOR PRACTICE Efforts to reduce GDM among those most at risk are needed, especially among racial and ethnic minorities. Increasing support for women with GDM to continue to breastfeed may improve maternal and child health outcomes and reduce health disparities, particularly among AI/AN women.
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Affiliation(s)
- Luciana E Hebert
- Institute for Research and Education to Advance Community Health (IREACH), 1100 Olive Way, Suite 1200, Seattle, WA, 98101, USA.
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA.
| | - Cassandra J Nikolaus
- Institute for Research and Education to Advance Community Health (IREACH), 1100 Olive Way, Suite 1200, Seattle, WA, 98101, USA
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Anna Zamora-Kapoor
- Institute for Research and Education to Advance Community Health (IREACH), 1100 Olive Way, Suite 1200, Seattle, WA, 98101, USA
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
- Department of Sociology, Washington State University, Pullman, WA, USA
| | - Ka'imi A Sinclair
- Institute for Research and Education to Advance Community Health (IREACH), 1100 Olive Way, Suite 1200, Seattle, WA, 98101, USA
- College of Nursing, Washington State University, Spokane, WA, USA
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Charron-Prochownik D, Moore KR, Stotz S, Akers A, Beirne S, Brega AG, Chalmers L, Fischl A, Garrow H, Gonzales K, Nadeau KJ, O'Banion N, Powell J, Seely E, Powell B, Abujaradeh H, Sereika SM. Comparing American Indian/Alaska Native Adolescent Daughters' and Their Mothers' Awareness, Knowledge, Attitudes, and Behaviors Regarding Risk for Gestational Diabetes: Implications for Mother-Daughter Communication on Reproductive Health. Sci Diabetes Self Manag Care 2023; 49:267-280. [PMID: 37332238 DOI: 10.1177/26350106231178837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
PURPOSE The purpose of the study was to describe, compare, and examine associations at baseline of reproductive health awareness, knowledge, health beliefs, communication and behaviors related to gestational diabetes (GDM) and GDM risk reduction in a vulnerable population of both American Indian/Alaska Native (AIAN) adolescent girls and their mothers. METHODS Descriptive/comparative/correlational analyses examined multitribal baseline data on 149 mother-daughter (M-D) dyads (N = 298; daughter age = 12-24 years) enrolled in a longitudinal study to adapt and evaluate a culturally relevant diabetes preconception counseling (PC) program (Stopping-GDM). The associations between GDM risk reduction awareness, knowledge, health beliefs, and behaviors (eg, daughters' eating, physical activity, reproductive-health [RH] choices/planning, M-D communication, daughters' discussions on PC) were examined. Data collected online from 5 national sites. RESULTS Many M-D lacked awareness/knowledge of GDM and risk reduction. Both M-D were unaware of the girl's risk for GDM. Mothers' knowledge and beliefs on GDM prevention/RH were significantly higher than daughters. Younger daughters had greater self-efficacy healthy living. Overall sample reported low to moderate scores for both M-D communication and daughters' GDM and RH risk-reduction behaviors. CONCLUSIONS Knowledge, communication, and behaviors to prevent GDM were low in AIAN M-D, especially daughters. More than daughters, mothers perceive greater risk of GDM for daughters. Early culturally responsive dyadic PC programs could help decrease risk of developing GDM. Implications for M-D communication is compelling.
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Affiliation(s)
| | - Kelly R Moore
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Sarah Stotz
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Sandra Beirne
- Navajo Area Indian Health Service, Shiprock, New Mexico
| | - Angela G Brega
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Andrea Fischl
- University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
| | | | | | - Kristen J Nadeau
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Nancy O'Banion
- Indian Health Care Resource Center of Tulsa, Tulsa, Oklahoma
| | - Jeff Powell
- University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
| | - Ellen Seely
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Blair Powell
- Navajo Area Indian Health Service, Shiprock, New Mexico
| | - Hiba Abujaradeh
- University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
| | - Susan M Sereika
- University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
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Stotz SA, Soon R, Moore KR, Charron-Prochownik D, Fischl A, Spencer K, Mau MK. A Qualitative Study on Preventing Gestational Diabetes in Native Hawaiian and Pacific Islander Adolescent Females: Perspectives from an Expert Panel of Health Care Providers. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:10-15. [PMID: 36685779 PMCID: PMC9850826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The authors examined perspectives of health care providers (HCPs) who serve Native Hawaiian and Pacific Islander (NH/PI) adolescents to inform the adaption of an existing American Indian and Alaska Native-specific gestational diabetes mellitus (GDM) risk reduction and preconception counseling program entitled Stopping GDM, for NH/PI adolescents. Hawai'i-based HCPs (n=14) who care for NH/PI adolescent females volunteered for this expert panel focus group study. These HCP participants served as an expert panel specific to their experiences in providing primary care and reproductive health care/family planning, and their perspectives regarding GDM risk reduction for NH adolescents. Several key themes emerged from these expert panel focus groups: (1) importance of multi-generational family involvement and support; (2) need to address the social determinants of health; (3) strengths-based strategies and recommendations to engage adolescents in a preconception counseling and GDM risk-reduction education program. Findings will inform the adaptation of Stopping GDM into a more holistic, multi-level, strengths-based, culturally tailored GDM risk reduction intervention that fosters empowerment and builds on the resilience of NH/PI communities.
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Affiliation(s)
- Sarah A. Stotz
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (SAS, KRM)
| | - Reni Soon
- John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (RS, KS, MM)
| | - Kelly R. Moore
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (SAS, KRM)
| | - Denise Charron-Prochownik
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, PA (AF, DC-P)
| | - Andrea Fischl
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, PA (AF, DC-P)
| | - Kim Spencer
- John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (RS, KS, MM)
| | - Marjorie K.L.M. Mau
- John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (RS, KS, MM)
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Charron-Prochownik D. It Takes a Brain, a Heart, Courage, and Support. Diabetes Spectr 2022; 35:245-251. [PMID: 35668886 PMCID: PMC9160540 DOI: 10.2337/ds22-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Editor's note: This article is adapted from the virtual address Dr. Charron-Prochownik delivered as the recipient of the American Diabetes Association's Outstanding Educator in Diabetes Award for 2021. She delivered the address in June 2021 during the Association's 81st Scientific Sessions, which was held online as a result of the coronavirus disease 2019 pandemic. A webcast of this speech is available for viewing on the DiabetesPro website (https://bit.ly/3Lry4B9).
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Moore KR, Stotz S, Abujaradeh H, Marshall G, Terry MA, Charron-Prochownik D. Reducing risk for gestational diabetes among American Indian and Alaska Native teenagers: Tribal leaders' recommendations. Int J Gynaecol Obstet 2021; 155:195-200. [PMID: 34331703 PMCID: PMC8893230 DOI: 10.1002/ijgo.13849] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/27/2021] [Accepted: 07/29/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To elicit feedback from tribal leaders and American Indian/Alaska Native (AI/AN) health system administrators as a national stakeholder perspective to inform the development of a gestational diabetes mellitus (GDM) risk reduction and preconception counseling intervention for AI/AN teenagers at high risk for GDM. METHODS A semi-structured focus group interview guide was developed by both principal investigators and qualitative methods experts. Using open-ended questions about the Reproductive-health Education and Awareness of Diabetes in Youth for Girls (READY-Girls) booklet and video clips, AI/AN health care system administrators and elected tribal leaders attending the 2015 National Indian Health Board Conference in Washington, DC, made recommendations on adaptation for an AI/AN audience. The focus group was recorded, transcribed verbatim, and analyzed by two researchers using an inductive coding technique with constant comparison method as supported by the grounded theory approach. RESULTS Recommendations from the 12 participants included: (1) the best ways to communicate with AI/AN teenagers, (2) the importance of parental, family, and community education and engagement to support AI/AN teenagers in GDM risk reduction, and (3) building on traditional AI/AN cultural values and practices, while accommodating differences between tribes and regions. CONCLUSION Findings from this focus group were used to inform the iterative development of a GDM risk reduction and preconception counseling intervention for AI/AN teenagers.
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Affiliation(s)
- Kelly R. Moore
- Centers for American Indian and Alaska Native Health, Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Sarah Stotz
- Centers for American Indian and Alaska Native Health, Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Hiba Abujaradeh
- Department of Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
| | - Gale Marshall
- Two Feathers Media, LLC, Canton, North Carolina, USA
| | - Martha A. Terry
- Graduate School of Public Health, Department of Behavioral and Community Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Denise Charron-Prochownik
- Department of Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
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