“We are competing with culture” the chasm between healthcare professionals and Australian Samoan women in the prevention and management of gestational diabetes mellitus | AJAN - The Australian Journal of Advanced Nursing Home Archives Vol. 40 No. 2 (2023): March - May 2023 Research Papers Main Article Content

Dorothy Ndwiga
Kate A McBride
Ronda Thompson
David Simmons
Freya MacMillan

Keywords

Gestational diabetes mellitus, Health Belief Model, healthy eating, healthcare services, physical activity, Samoan women

Abstract

Objective: The Samoan community has a disproportionately higher incidence of gestational diabetes mellitus (GDM). We explored consumer and healthcare providers’ insight into perceptions of risk, attitudes to lifestyle behaviour change and experiences of GDM among Australian Samoan women in South Western Sydney. Methods: Semi-structured interviews and a focus group with Samoan women recruited through three churches, a diabetes and pregnancy clinic in South Western Sydney and via social media were conducted. Semi-structured interviews with healthcare providers’ were also conducted. Main themes were thematically analysed to identify recurring patterns using Quirkos software. Identified themes were framed against the constructs of the Health Belief Model. Results: One focus group (n=4) and 12 one-to one interviews were conducted among Samoan women. Eighteen semi-structured interviews with healthcare providers’ were also conducted. There was a high concordance between Samoan women and healthcare providers’ regarding perception of risk and barriers to maintaining a healthy lifestyle. However, Samoan women reported negative interactions with healthcare providers’ that hindered their behaviour change, while healthcare providers’ reported that normalisation of diabetes, confusion of GDM with type 2 diabetes and spiritual health beliefs were deterrents to behaviour change among Samoan women. Conclusion: Cross-cultural factors can influence the uptake of a healthy lifestyle. Future research should consider use of culturally tailored strategies when developing educational resources targeting Samoan women. Implications for research, policy and practice: The participants’ viewpoints expressed in this study suggest a critical need for the development of culturally-tailored health promotion strategies for Samoan women and cultural training for healthcare providers’, to improve GDM care and subsequent pregnancy outcomes.

What is already known about the topic?

There is limited data and research on GDM particularly among the Australian-Samoan community though the available data highlight the significant morbidity and mortality due to diabetes in this population.
Samoan women are at an increased risk of gestational diabetes mellitus.

What this paper adds:

This paper provides knowledge and understanding on ways to prevent and manage GDM by investigating the perception of risk and experiences of GDM among Australian Samoan women and healthcare professionals in Sydney.
It provides current evidence base for policy makers and researchers to develop health promotion strategies and interventions that are relevant to the Samoan and other culturally and linguistically diverse (CALD) communities in Australia.
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How to Cite

1.

Ndwiga D, McBride KA, Thompson R, Simmons D, MacMillan F. “We are competing with culture” the chasm between healthcare professionals and Australian Samoan women in the prevention and management of gestational diabetes mellitus . Aust J Adv Nurs [Internet]. 2023 May 31 [cited 2023 Jul. 25];40(2). Available from: https://www.ajan.com.au/index.php/AJAN/article/view/591

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