title: Operationalizing and Examining Family Planning Vigilance in Adult Women With Type 1 Diabetes.
abstract: Because unplanned pregnancies could cause maternal-fetal complications for women with diabetes, family planning vigilance (FPV) is imperative. The aims of this article are to operationalize and describe FPV and examine the associations among FPV behaviors and diabetes self-care management (DSM) and health outcomes of women with type 1 diabetes (T1D).
  
  
  
  Retrospective data were used from a follow-up study of adult women with T1D who participated as adolescents in a preconception counseling (PC) intervention trial and matched comparison women with T1D who did not receive the adolescent PC intervention. Participants completed online questionnaires regarding family planning behaviors, DSM, and clinical and reproductive health outcomes.
  
  
  
  Participants (N = 102) were, on average, 23.7 years old (range 18-38) and 98.0% were white, 82.2% had some college, 25.8% were married, and 11.8% had biological children. Of those sexually active (n = 80, 78.4%), 50% were contraceptive vigilant and 11% were FPV (i.e., being contraceptive vigilant, receiving PC, and initiating discussions with health care professionals). Among FPV behaviors, only receiving PC and initiating discussion with health care professionals were correlated (r = 0.29, P = 0.010). Compared with nonvigilant women, contraceptive vigilant and FPV women used more effective contraceptive methods (P = 0.025) and experienced less diabetic ketoacidosis (P = 0.040) and hospitalizations (P = 0.064), whereas FPV women were aware of PC (P = 0.046) and younger when they received PC (P < 0.001). FPV components were associated with DSM and health outcomes (P < 0.05).
  
  
  
  Women with diabetes should be FPV, but few were. FPV women were more likely to have PC earlier and better health outcomes, supporting early PC intervention.
authors.affiliation: School of Nursing, University of Pittsburgh, Pittsburgh, PA ssereika@pitt.edu.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sereika
authors.affiliation: Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Becker
authors.affiliation: School of Nursing, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Schmitt
authors.affiliation: School of Nursing, University of Pittsburgh, Pittsburgh, PA.
authors.forename: A Blair
authors.initials: AB
authors.lastname: Powell
authors.affiliation: Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Diaz
authors.affiliation: School of Nursing, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Andrea F R
authors.initials: AF
authors.lastname: Fischl
authors.affiliation: School of Nursing, University of Pittsburgh Johnstown, Johnstown, PA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Thurheimer-Cacciotti
authors.affiliation: Schools of Medicine and Public Health, University of Michigan, Ann Arbor, MI.
authors.forename: William H
authors.initials: WH
authors.lastname: Herman
authors.affiliation: School of Nursing, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Denise
authors.initials: D
authors.lastname: Charron-Prochownik
mesh_terms: D000293:Adolescent; D000328:Adult; D001364:Awareness; D003267:Contraception; D003376:Counseling; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D005193:Family Planning Services / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009042:Motivation; D016742:Preconception Care; D012189:Retrospective Studies; D012648:Self Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult