title: Reasons for women's non-participation in follow-up screening after gestational diabetes.
abstract: BACKGROUND
  Due to the increased risk of type 2 diabetes, follow-up screening after birth is recommended to women with previous gestational diabetes. Low participation in such screening has been shown to delay detection of diabetes with potentially serious consequences for the women's future health. The women's experiences of treatment and care during their pregnancies may affect participation.
  
  
  OBJECTIVE
  This study aimed at understanding the women's experiences with treatment and care during pregnancy and to understand how these experiences influence participation in follow-up screening.
  
  
  METHODS
  A qualitative study was undertaken drawing on a phenomenological methodology. Seven women treated for gestational diabetes at a university hospital in the North Denmark Region participated in interviews.
  
  
  RESULTS
  The women experienced lack of continuity in care between hospital departments and health sectors. We identified the following causes for low participation in follow-up screening: poor coordination, little elaboration of information, a lack of clear coordination of responsibility for follow-up screening among health care professionals and absence of focus and inclusion of their individual needs and preferences.
  
  
  CONCLUSIONS
  The women wished to be reminded of screening to increase their sense of safety. The women's experiences seem to reflect a lack of patient-centeredness during the pregnancy, which may be remedied by increasing the focus on the women's need for improved continuity in treatment and care. Participation in follow-up screening after gestational diabetes may be increased by sending reminders to the women. Raised awareness of the women's individual needs and preferences for treatment and care offers potential for improvement.
authors.affiliation: Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej, 14, 9220 Aalborg Øst, Denmark; Department of Midwifery, University College of Northern Denmark, Selma Lagerløfs Vej 2, 9220 Aalborg Øst, Denmark. Electronic address: janenielsen@outlook.dk.
authors.forename: Jane Hyldgaard
authors.initials: JH
authors.lastname: Nielsen
authors.affiliation: Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej, 14, 9220 Aalborg Øst, Denmark. Electronic address: christinnaolesen@gmail.com.
authors.forename: Christinna Rebecca
authors.initials: CR
authors.lastname: Olesen
authors.affiliation: Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej, 14, 9220 Aalborg Øst, Denmark. Electronic address: tmk@hst.aau.dk.
authors.forename: Tine Mechlenborg
authors.initials: TM
authors.lastname: Kristiansen
authors.affiliation: Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej, 14, 9220 Aalborg Øst, Denmark. Electronic address: ckb@hst.aau.dk.
authors.forename: Carsten Kronborg
authors.initials: CK
authors.lastname: Bak
authors.affiliation: Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej, 14, 9220 Aalborg Øst, Denmark. Electronic address: co@hst.aau.dk.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Overgaard
mesh_terms: D000328:Adult; D003657:Decision Making; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008403:Mass Screening / Q000379:methods*; D036801:Parturition; D010349:Patient Compliance; D018802:Patient-Centered Care; D049590:Postpartum Period; D011247:Pregnancy; D036301:Qualitative Research; D017010:Reminder Systems; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Decision-making; Gestational diabetes; Patient compliance; Patient-centred care; Reminder systems