224629 A community-based approach to improving postpartum health in women in East Harlem with histories of Gestational Diabetes

Tuesday, November 9, 2010

Ellen Plumb , Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA
Mischka Garel, MPH , Mount Sinai School of Medicine, Department of Health Policy, Communities IMPACT Diabetes Center, New York, NY
Michelle Ramos, MPH , Union Settlement Association/ Mount Sinai School of Medicine, Communities IMPACT Diabetes Center, New York, NY
Fernanda Espinosa , Department of Health Policy, Mount Sinai School of Medicine, New York, NY
Carol Horowitz, MD, MPH , Departments of Health Policy and Medicine, Mount Sinai School of Medicine, New York, NY
Background: In the past ten years, NYC has seen a dramatic increase in the prevalence of gestational diabetes (GDM). This study aimed to use a community-based participatory approach to understand how social, cultural, and economic factors impact postpartum health in women in East Harlem with a history of GDM. Methods: We conducted in-depth interviews with providers and a combined focus group-photovoice project with women with histories of GDM. Participants were recruited from a major academic hospital, community health clinics, and social service organizations. Experienced moderators facilitated interviews, focus groups, and the photovoice project. Two researchers independently coded the transcripts, identified major themes, and compared findings. Differences were resolved through discussion and consensus. Results: Several major influences on postpartum health have been identified. From a provider perspective, these include: 1) communication failures between providers; 2) location of care received; and 3) the socioeconomic and cultural status of patients. From a patient perspective, these include: 1) access, quality, and cost of care; 2) family support; and 3) child health concerns. Discussion: Exploring the barriers to postpartum health among women with a history of GDM from both a provider and patient perspective will aid in the development of community-focused initiatives aimed at improving the way that postpartum care is delivered to and accessed by women at increased risk of developing Type 2 Diabetes.

Learning Areas:
Chronic disease management and prevention
Public health or related organizational policy, standards, or other guidelines
Social and behavioral sciences

Learning Objectives:
Describe an innovative community-focused research approach to understanding barriers to postpartum health in women with histories of gestational diabetes.

Keywords: Prevention, Barriers to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: medical student with a background in anthropology and public health
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.