Abstract

Background: American Indian/Alaska Native (AIAN) women have twice the risk compared to the general US population of adolescent obesity, pregnancy, and gestational diabetes. The purpose of this study was to explore the perspectives of adolescent AIAN girls who are at risk for gestational diabetes (GDM) on their awareness and understanding of GDM and reproductive health; and on an existing validated diabetes and preconception counseling (PC) education program for non-AIAN teen girls with diabetes.

Methods: Five semi-structured focus group interviews with 13 AIAN females (age 15.5±1.8 years) were conducted. Questions related to their awareness, understanding, and perceptions of risk for GDM. The moderator also showed video clips and booklet excerpts from the existing program to elicit feedback. Interviews were recorded and transcribed verbatim. Analysis included inductive coding and the constant comparison method.

Results: Key themes were constructed: 1) Lack of awareness and knowledge of GDM; 2) Need for pregnancy planning and culturally responsive GDM and reproductive health resources; 3) Importance of using empowerment frameworks to promote positive reproductive health behaviors.

Conclusions: The participants’ lack of awareness and knowledge of GDM and their risk for developing GDM reveals the need for new health programming to mitigate risk for unplanned pregnancies and GDM, and to promote healthy pregnancy and birth outcomes. These findings have been used in conjunction with findings of focus groups of other key stakeholders to inform the development of a culturally tailored GDM risk reduction program for AIAN adolescents.

Keywords: American Indian and Alaska Native, adolescents, gestational diabetes, reproductive health, preconception counseling