title: Cardiometabolic risk, knowledge, risk perception, and self-efficacy among American Indian women with previous gestational diabetes.
abstract: OBJECTIVE
  To describe cardiometabolic risk among a sample of American Indian women with previous gestational diabetes and describe the women's knowledge, risk perception for type 2 diabetes and cardiovascular disease, and self-efficacy beliefs related to preventing these diseases.
  
  
  METHODS
  Mixed methods, cross-sectional, exploratory, descriptive.
  
  
  METHODS
  Four campuses within one American Indian tribal health care system in a southwestern state.
  
  
  METHODS
  A purposeful sample of 22 self-identified American Indian women with a history of gestational diabetes.
  
  
  METHODS
  Qualitative interview data were subjected to content analysis, and descriptive statistics were used to analyze quantitative questionnaire data and biophysiologic data.
  
  
  RESULTS
  The majority of participants (13 of 21) were classified as having metabolic syndrome, and 13 of 18 women were found to be insulin resistant. In general, the women had high levels of knowledge related to type 2 diabetes and cardiovascular disease and high risk perception, but low self-efficacy related to preventing cardiometabolic disease. The overarching theme from the in-depth interviews, struggling to change lifestyle behaviors while doubting prevention is possible, encompassed four categories that provided further illumination into participants' risk perceptions and self-efficacy beliefs: concerns, control, beliefs/attitudes, and prevention.
  
  
  CONCLUSIONS
  High levels of knowledge and risk perception do not necessarily promote increased self-efficacy to prevent cardiometabolic disease among American Indian women with previous gestational diabetes. Findings indicate the need to further explore women's self-efficacy beliefs in the context of American Indian culture prior to developing interventions aimed at increasing self-efficacy to prevent or delay type 2 diabetes and cardiovascular disease. Women with previous gestational diabetes are at increased risk for developing cardiovascular disease, independent of a diagnosis of type 2 diabetes.
authors: College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA.. Electronic address: emily.jones@umb.edu.
authors: Emily J
authors: EJ
authors: Jones
authors: Capstone College of Nursing, University of Alabama, Tuscaloosa, AL.
authors: Susan J
authors: SJ
authors: Appel
authors: School of Nursing, University of Alabama, Birmingham, AL.
authors: Yvonne D
authors: YD
authors: Eaves
authors: School of Nursing, University of Alabama, Birmingham, AL.
authors: Linda
authors: L
authors: Moneyham
authors: Department of Medicine, Division of Preventive Medicine, University of Alabama, Birmingham, AL.
authors: Robert A
authors: RA
authors: Oster
authors: Diabetes & Endocrine Clinical Research Unit in the Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Alabama, Birmingham, AL.
authors: Fernando
authors: F
authors: Ovalle
mesh_terms: D000328:Adult; D000367:Age Factors; D001294:Attitude to Health / Q000208:ethnology*; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006306:Health Surveys; D006801:Humans; D007198:Indians, North American; D008019:Life Style / Q000208:ethnology; D024821:Metabolic Syndrome / Q000208:ethnology / Q000503:physiopathology; D008875:Middle Aged; D010298:Parity; D010465:Perception; D011247:Pregnancy; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D020377:Self Efficacy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult