title: Mother-daughter dyadic approach for starting preconception counseling at puberty in girls with diabetes.
abstract: BACKGROUND
  Preconception counseling (PC) significantly and inexpensively reduces risks of reproductive-health complications for women with diabetes. Our validated technology-based preconception counseling intervention,READY-Girls, is tailored for female teens with type 1 (T1D) and type 2 (T2D) diabetes and targets decision-making regarding effective family planning and seeking PC. Our teen-focused research was instrumental in changing the American Diabetes Association's Practice Recommendations to specify that preconception counseling should "Start at puberty…". This directive requires support from well-informed mothers of teens. Our goal is to provide both teen girls and their mothers with preconception counseling knowledge, and provide mothers with sex-communication training. Evaluation should focus on mother-daughter dyads.
  
  
  OBJECTIVE
  This feasibility study explored mother's and daughter's awareness and knowledge of diabetes and pregnancy, and preconception counseling; and compared mother-daughter responses using dyadic analyses.
  
  
  METHODS
  A mixed-method design was conducted with 10 mothers of daughters with T1D. Mothers were givenREADY-Girlsintervention and completed knowledge and support questionnaires. Their responses were compared to those of their daughter's who were participating in a large randomized, control intervention trial withREADY-Girls.
  
  
  RESULTS
  The major theme from one-on-one interviews was, "I know nothing about diabetes/pregnancy risks and PC". Mother's and daughter's perceptions of having limited knowledge were confirmed by low knowledge scores. Mothers perceived giving higher levels of support compared to their daughter's perceptions of receiving support.
  
  
  CONCLUSIONS
  Mothers can play a vital role in initiating discussions regarding reproductive-health with their daughters and reinforcing preconception counseling. Mother-daughter team approach for starting preconception counseling at puberty in girls with diabetes is feasible. Mother-daughter dyadic analyses can be important to explore possible mediating and moderating roles of mother-daughter communication and support about reproductive health on the relationship betweenREADY-Girlsintervention and sustainable outcomes.
authors: Department of Health Promotion & Development, University of Pittsburgh, School of Nursing, USA.
authors: Denise
authors: D
authors: Charron-Prochownik
authors: Department of Health Promotion & Development, University of Pittsburgh, School of Nursing, USA.
authors: Andrea Rodgers
authors: AR
authors: Fischl
authors: Department of Health Promotion & Development, University of Pittsburgh, School of Nursing, USA.
authors: Jessica
authors: J
authors: Choi
authors: Department of Health Promotion & Development, University of Pittsburgh, School of Nursing, USA.
authors: Patricia L
authors: PL
authors: Schmitt
authors: Department of Pediatrics, Washington University in St. Louis, and St. Louis Children's Hospital, St. Louis, Missouri, USA.
authors: Neil H
authors: NH
authors: White
authors: Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, USA.
authors: Dorothy
authors: D
authors: Becker
authors: Center for Risk Perception and Communication, Carnegie Mellon University, USA.
authors: Julie
authors: J
authors: Downs
authors: Department of Health Promotion & Development, University of Pittsburgh, School of Nursing, USA.
authors: Margaret
authors: M
authors: Hannan
authors: Department of Health Promotion & Development, University of Pittsburgh, School of Nursing, USA.
authors: Jennifer
authors: J
authors: Thurheimer
authors: Center for Research and Evaluation, School of Nursing, University of Pittsburgh, USA.
authors: Susan M
authors: SM
authors: Sereika
keywords: Diabetes mellitus; adolescence; family planning; mother-child relation; reproductive health