title: Strategies to optimize participation in diabetes prevention programs following gestational diabetes: a focus group study.
abstract: OBJECTIVE
  We performed a qualitative study among women within 5 years of Gestational Diabetes (GDM) diagnosis. Our aim was to identify the key elements that would enhance participation in a type 2 diabetes (DM2) prevention program.
  
  
  METHODS
  Potential participants received up to three invitation letters from their GDM physician. Four focus groups were held. Discussants were invited to comment on potential facilitators/barriers to participation and were probed on attitudes towards meal replacement and Internet/social media tools. Recurring themes were identified through qualitative content analysis of discussion transcripts.
  
  
  RESULTS
  Among the 1,201 contacted and 79 eligible/interested, 29 women attended a focus group discussion. More than half of discussants were overweight/obese, and less than half were physically active. For DM2 prevention, a strong need for social support to achieve changes in dietary and physical activity habits was expressed. In this regard, face-to-face interactions with peers and professionals were preferred, with adjunctive roles for Internet/social media. Further, direct participation of partners/spouses in a DM2 prevention program was viewed as important to enhance support for behavioural change at home. Discussants highlighted work and child-related responsibilities as potential barriers to participation, and emphasized the importance of childcare support to allow attendance. Meal replacements were viewed with little interest, with concerns that their use would provide a poor example of eating behaviour to children.
  
  
  CONCLUSIONS
  Among women within 5 years of a GDM diagnosis who participated in a focus group discussion, participation in a DM2 prevention program would be enhanced by face-to-face interactions with professionals and peers, provision of childcare support, and inclusion of spouses/partners.
authors.affiliation: Department of Medicine, McGill University, Montreal, Quebec, Canada. kaberi.dasgupta@mcgill.ca
authors.forename: Kaberi
authors.initials: K
authors.lastname: Dasgupta
authors.forename: Deborah
authors.initials: D
authors.lastname: Da Costa
authors.forename: Sabrina
authors.initials: S
authors.lastname: Pillay
authors.forename: Mirella
authors.initials: M
authors.lastname: De Civita
authors.forename: Réjeanne
authors.initials: R
authors.lastname: Gougeon
authors.forename: Aaron
authors.initials: A
authors.lastname: Leong
authors.forename: Simon
authors.initials: S
authors.lastname: Bacon
authors.forename: Stephen
authors.initials: S
authors.lastname: Stotland
authors.forename: V Tony
authors.initials: VT
authors.lastname: Chetty
authors.forename: Natasha
authors.initials: N
authors.lastname: Garfield
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Majdan
authors.forename: Sara
authors.initials: S
authors.lastname: Meltzer
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000517:prevention & control*; D016640:Diabetes, Gestational / Q000503:physiopathology / Q000523:psychology*; D004032:Diet; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D017144:Focus Groups / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D009765:Obesity / Q000503:physiopathology / Q000523:psychology*; D011247:Pregnancy; D036301:Qualitative Research; D012944:Social Support