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Healthy Cities 21st Century

Women with Diabetes

Health Literacy

Organisation: 
Queen's University Belfast
Date of Project: 
2010 - 2015
Geography of Project: 
Developed by QUB, South Eastern and Belfast Health and Social Care Trusts, Regional roll out
Keywords: 
pregnancy, diabetes, perinatal care
Aim, Background, What Happened: 

Babies born to women with diabetes are more likely to be affected by congenital anomalies, including spina bifida, heart and kidney anomalies. However, it is well established that good blood glucose control before and during pregnancy can reduce this risk.

Context of Community or Target Group: 

Preconception counselling aims to inform women with diabetes about the importance of planning for pregnancy, with healthcare professionals encouraged to have this ‘conversation’ with women at every contact from adolescence. However, healthcare professionals need to feel confident in their knowledge of diabetes and pregnancy planning if they are to have that all important preconception counselling conversation with women during routine consultations.

Dr Michael McBride, Chief Medical Officer, said: “The rate of diabetes is increasing in our population, including among women of childbearing age. It is therefore essential that women with diabetes are aware of how important it is to plan for pregnancy … I would encourage everyone working in the fields of diabetes and reproductive health to complete the e-learning modules on the website. If we can empower ourselves as healthcare professionals to discuss pregnancy planning and care with women who have diabetes, we can empower the women themselves to seek advice and support and to take ownership of their condition.”

Women tend not to plan around issues of pregnancy, this resource will provide information for women before and during pregnancy and for the health professional supporting them.

Influences on Case Study: 

The project was preceded by a DVD “Women with Diabetes: Things you need to know but maybe don’t!” funded by Diabetes UK in 2010. Women who viewed the DVD were more likely to plan for pregnancy and to take folic acid. The online website adaption (www.womenwithdiabetes.net) was supported by a Knowledge Transfer Award from the Public Health Agency.

Policy and Other Problems: 

The project was advertised through a poster and flyer campaign, delivered to all GP surgeries and community pharmacies. Therefore the project was reliant on practice manager distributing information and displaying posters.

Prior Experience with Health Literacy Across Sectors: 

The project was developed by researchers at Queen’s University Belfast, Northern Ireland, in conjunction with the South Eastern and Belfast Health and Social Care Trusts, have developed a new preconception counselling website.

Concept of Health and Health Literacy: 

Health literacy not specifically mentioned however the project aims to increase women’s knowledge of pre pregnancy planning.

Mandate of Project: 

NICE guidelines 2014 - Antenatal and postnatal mental health: clinical management and service guidance.

Prioritisation of Issue: 

NICE guidelines, perinatal care

Formal Processes: 

“The views and experiences of women with diabetes have been central to the development of these resources. The DVD and the internationally available website we have produced build on their needs before, during and after pregnancy so they can plan and feel confident about their pregnancy.”

A steering group for the project includes representatives from public health, GPs, pharmacy and QUB.

Availability of Resources: 

The DVD resource and website are available internationally. The programme was funded through a Knowledge Exchange grant.

Capacity-Building Activities: 

Evidence based clinically relevant e-resources for health professionals to build capacity to advise women on pregnancy planning and during pregnancy. Resource also has advice for women who are considering pregnancy or are pregnant.

Social Mechanisms: 

Preconception counselling aims to inform women with diabetes about the importance of planning for pregnancy, with healthcare professionals encouraged to have this ‘conversation’ with women at every contact from adolescence. However, healthcare professionals need to feel confident in their knowledge of diabetes and pregnancy planning if they are to have that all important preconception counselling conversation with women during routine consultations. Women and health care professionals interested in knowing more can access the DVD and website for more information.

Acceptability: 

The project was developed in partnership with women with diabetes. The resource for health professionals was evidence based and clinically relevant. The Women with Diabetes website has a feedback form to improve and rate the resources. The website continuously monitored and can be updated by QUB based on feedback.

Feasiblity: 

As well as a website helping women to prepare for pregnancy, the resource now encompasses an evidence based e-learning component aimed at all healthcare professionals who care for women with diabetes - GPs, pharmacists, practice nurses etc. The resource offers a unique opportunity to educate both women and healthcare professionals on the importance of planning for pregnancy. The ultimate aim of this e-learning resource is to improve uptake of pre-pregnancy care by increasing rates of preconception counselling in both primary and secondary care.

The website has links to pre pregnancy care clinics and contact details of who to speak to.

Sustainability: 

The project was preceded by a DVD “Women with Diabetes: Things you need to know but maybe don’t!” funded by Diabetes UK in 2010. Women who viewed the DVD were more likely to plan for pregnancy and to take folic acid. The online website adaption (www.womenwithdiabetes.net) was supported by a Knowledge Transfer Award from the Public Health Agency.

The website is monitored and updated continuously and administered by QUB therefore easy to change and add material.

Other Comments / Information: 

The e-learning resource can account for Continuous Professional Development for Health Care Professional, including pharmacists. The project modules are also included in GP training programmes across NI, within the School of Nursing at QUB and adopted by two other universities across the UK. The information has been informed the work of perinatal research groups and supports the new NICE guidelines.

Headline Message(s): 

Even if a baby is the last thing on your mind there are still things you need to know.

Evaluation: 

The online resource was developed from a research project at Queens University. Evaluation methods included a pre-DVD and post-DVD intervention study by postal questionnaire and focus groups. Articles with details on the evaluations of the project are available on the project website.

Further Information: 

Project website - www.womenwithdiabetes.net

Twitter- www.twitter.com/DiabetesWomen

For further information please contact Anne McCusker at Belfast Health Cities anne@belfastheatlhycities.com or 028 9032 8811.