Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/11100
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dc.contributor.authorKlein, J-
dc.contributor.authorBoyle, J A-
dc.contributor.authorKirkham, R-
dc.contributor.authorConnors, C-
dc.contributor.authorWhitbread, C-
dc.contributor.authorOats, J-
dc.contributor.authorBarzi, F-
dc.contributor.authorMcIntyre, D-
dc.contributor.authorLee, I-
dc.contributor.authorLuey, M-
dc.contributor.authorShaw, J-
dc.contributor.authorBrown, A D H-
dc.contributor.authorMaple-Brown, L J-
dc.date2017-
dc.date.accessioned2018-05-15T23:00:32Z-
dc.date.accessioned2019-06-29T00:40:36Z-
dc.date.available2018-05-15T23:00:32Z-
dc.date.available2019-06-29T00:40:36Z-
dc.date.issued2017-07-
dc.identifier.citationDiabetes research and clinical practice 2017-07; 129: 105-115-
dc.identifier.urihttp://docs.prosentient.com.au/prosentientjspui/handle/1/11100-
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.-
dc.language.isoeng-
dc.subjectAboriginal health-
dc.subjectDiabetes in pregnancy-
dc.subjectPreconception care-
dc.subjectType 2 diabetes mellitus-
dc.subject.meshAdult-
dc.subject.meshCross-Sectional Studies-
dc.subject.meshDiabetes Mellitus, Type 2-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshPreconception Care-
dc.subject.meshPregnancy-
dc.subject.meshPregnancy Complications-
dc.titlePreconception care for women with type 2 diabetes mellitus: A mixed-methods study of provider knowledge and practice.-
dc.typeJournal Article-
dc.identifier.doi10.1016/j.diabres.2017.03.035-
dc.identifier.journaltitleDiabetes research and clinical practice-
dc.identifier.pubmedurihttps://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/28521194-
dc.identifier.pubmedidhttps://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/28521194-
dc.identifier.affiliationRoyal Darwin Hospital, Darwin, Australia; Department of Obstetrics and Gynaecology, Eastern Health, Melbourne, Australia..-
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..-
dc.identifier.affiliationMenzies School of Health Research, Darwin, Australia..-
dc.identifier.affiliationNorthern Territory Department of Health, Darwin, Australia..-
dc.identifier.affiliationRoyal Darwin Hospital, Darwin, Australia; Menzies School of Health Research, Darwin, Australia..-
dc.identifier.affiliationMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia..-
dc.identifier.affiliationMenzies School of Health Research, Darwin, Australia..-
dc.identifier.affiliationMater Medical Research Institute, University of Queensland, Brisbane, Australia..-
dc.identifier.affiliationMenzies School of Health Research, Darwin, Australia..-
dc.identifier.affiliationCentral Australian Aboriginal Congress, Alice Springs, Australia..-
dc.identifier.affiliationBaker IDI Heart and Diabetes Institute, Melbourne, Australia..-
dc.identifier.affiliationSouth Australian Health and Medical Research Institute, Adelaide, Australia; University of South Australia, Adelaide, Australia..-
dc.identifier.affiliationRoyal Darwin Hospital, Darwin, Australia; Menzies School of Health Research, Darwin, Australia. Electronic address: louise.maple-brown@menzies.edu.au..-
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