"A patient should not have to ask": Women's experiences of patient education about preconception care for type 2 diabetes

Abstract

Objectives: To characterize perspectives and experiences regarding preconception care (PCC) patient education among women with type 2 diabetes.

Method: Descriptive, qualitative research design. Thirty-two English-speaking women with type 2 diabetes identifying as Black and/or Latina, ages 18-40 years old, participated. We conducted semi-structured interviews about PCC perspectives and experiences which we analyzed with conventional content analysis. To enhance rigor, we collected freelisting data from which we calculated salience scores. We triangulated our qualitative findings with salience scores.

Results: We identified three themes. Our first theme concerned mismatch between women's desires for PCC counseling to be frequent in contrast with their experiences of its infrequency. Our second theme captured how women felt responsible for initiating care in the clinical encounter but uncertain about what they "should" be asking for. Our third theme characterized women's perspectives on receiving information about PCC and pregnancy planning.

Conclusions: Young adult women with type 2 diabetes who are Black and/or Latina welcome more education about how PCC can prevent obstetrical complications associated with diabetes, which disproportionately affect their communities.

Practice implications: Our findings provide actionable suggestions for improving acceptability and accessibility of PCC patient education in the United States where PCC awareness and uptake are low.

Keywords: Diabetes mellitus, Type 2; Minority health; Preconception care; Self-management; Women.