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

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.