“It Empowers You to Empower Them”: Health Professional Perspectives of Care for Hyperglycaemia in Pregnancy Following a Multi-Component Health Systems Intervention

Diana MacKay (), Louise Maple-Brown, Natasha Freeman, Jacqueline A. Boyle, Sandra Campbell, Anna McLean, Sumaria Corpus, Cherie Whitbread, Paula Van Dokkum, Christine Connors, Elizabeth Moore, Ashim Sinha, Yvonne Cadet-James, John Boffa, Sian Graham, Jeremy Oats, Alex Brown, H. David McIntyre and Renae Kirkham
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Diana MacKay: Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia
Louise Maple-Brown: Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia
Natasha Freeman: Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia
Jacqueline A. Boyle: Eastern Health Clinical School, Monash University, Melbourne 3128, Australia
Sandra Campbell: Jawun Research Centre, Central Queensland University, Cairns 4870, Australia
Anna McLean: Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia
Sumaria Corpus: Department of Diabetes, Royal Darwin Hospital, Darwin 0810, Australia
Cherie Whitbread: Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia
Paula Van Dokkum: Alice Springs Hospital, Alice Springs 0870, Australia
Christine Connors: Northern Territory Department of Health, Darwin 0800, Australia
Elizabeth Moore: Aboriginal Medical Services Alliance Northern Territory, Darwin 0800, Australia
Ashim Sinha: Department of Diabetes and Endocrinology, Cairns and Hinterland Hospital and Health Service, Cairns 4870, Australia
Yvonne Cadet-James: Apunipima Cape York Health Council, Bungalow 4870, Australia
John Boffa: Central Australian Aboriginal Congress, Alice Springs 0800, Australia
Sian Graham: Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia
Jeremy Oats: Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3053, Australia
Alex Brown: College of Health and Medicine, Australian National University, Canberra 2601, Australia
H. David McIntyre: Mater Research, The University of Queensland, Brisbane 4101, Australia
Renae Kirkham: Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia

IJERPH, 2024, vol. 21, issue 9, 1-17

Abstract: The Northern Territory (NT) and Far North Queensland (FNQ) have a high proportion of Aboriginal and Torres Strait Islander women birthing who experience hyperglycaemia in pregnancy. A multi-component health systems intervention to improve antenatal and postpartum care in these regions for women with hyperglycaemia in pregnancy was implemented between 2016 and 2019. We explored health professional perspectives on the impact of the intervention on healthcare. The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) underpinned this mixed-methods evaluation. Clinicians were surveyed before ( n = 183) and following ( n = 137) implementation. The constructs explored included usual practice and satisfaction with care pathways and communication between services. Clinicians, policymakers and the implementation team were interviewed ( n = 36), exploring the impact of the health systems intervention on practice and systems of care. Survey and interview participants reported improvements in clinical practice and systems of care. Self-reported glucose screening practices improved, including the use of recommended tests (72.0% using recommended first-trimester screening test at baseline, 94.8% post-intervention, p < 0.001) and the timing of postpartum diabetes screening (28.3% screening at appropriate interval after gestational diabetes at baseline, 66.7% post-intervention, p < 0.001). Health professionals reported multiple improvements to care for women with hyperglycaemia in pregnancy following the health systems intervention.

Keywords: diabetes in pregnancy; gestational diabetes; health systems; quality improvement; Aboriginal health; First Nations; mixed methods (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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