"We are competing with culture" the chasm between healthcare professionals and Australian Samoan women in the prevention and management of gestational diabetes mellitus

Journal article


Ndwiga, Dorothy W., McBride, Kate A., Thompson, Ronda, Simmons, David and MacMillan, Freya. (2023). "We are competing with culture" the chasm between healthcare professionals and Australian Samoan women in the prevention and management of gestational diabetes mellitus. Australian Journal of Advanced Nursing. 40(2), pp. 5-14. https://doi.org/10.37464/2023.402.591
AuthorsNdwiga, Dorothy W., McBride, Kate A., Thompson, Ronda, Simmons, David and MacMillan, Freya
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.

Keywordsgestational diabetes mellitus; Health Belief Model; healthy eating; healthcare services; physical activity; Samoan women
Year2023
JournalAustralian Journal of Advanced Nursing
Journal citation40 (2), pp. 5-14
PublisherAustralian Nursing & Midwifery Federation
ISSN0813-0531
Digital Object Identifier (DOI)https://doi.org/10.37464/2023.402.591
Scopus EID2-s2.0-85161963057
Page range5-14
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online31 May 2023
Publication process dates
Deposited01 Apr 2025
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