Table 1.
Characteristics of the studies included in the qualitative synthesis
| First author and year | Sample size | Setting (country) | Study aim(s) relevant to this analysis | Recruitment strategy | Key inclusion/exclusion criteria | Method of data collection | Time of data collection* | Quality rating (CASP checklist) |
|---|---|---|---|---|---|---|---|---|
| Graco 2009 24 | 10 | Australia | To explore perceptions of PA among women with previous GDM, in context of Type 2 diabetes prevention | Purposive sampling (adverts at maternal and child health centres) | hGDM, English‐speaking, age ≥18 years, residence in selected area, not pregnant or since developed Type 2 diabetes | Interviews (not specified) | NR | 8.0 |
| Doran 2010 53 | 11 | Tonga | To explore how GDM diagnosis influenced change in diet and PA, influencing factors and support of sustained change | Purposive sampling (hospital records) | hGDM within 1 year, delivered baby at the recruiting hospital | Interviews (face‐to‐face) | Within 1 year | 7.0 |
| Evans 2010 37 | 16 | Canada | To determine perceived health status and experiences in establishing and maintaining healthy lifestyle changes | Purposive sampling (GDM clinic) | hGDM, English‐speaking, in the final trimester of pregnancy, telephone access | Interviews (not specified) | At 6 weeks, 3 and 6 months, and 1 year | 8.5 |
| Lindmark 2010 36 | 10 | Sweden | To investigate perceptions about lifestyle | Recruited from outpatient endocrinology hospital clinic by mailout | hGDM within 1 year, Swedish‐speaking, age 30–40 years, no other known diseases | Interviews (face‐to‐face) | At 1 year | 8.5 |
| Razee 2010 30 | 57 | Australia | To explore beliefs, attitudes, social support, environmental influences etc. on diabetes risk behaviours; preferred forms of programme delivery to inform health promotion | Purposive sampling (GDM hospital clinic databases via letter) | hGDM within 6–36 months, Cantonese‐, Mandarin‐, Arabic‐ or English‐speaking, not pregnant or since developed Type 2 diabetes | Interviews (telephone) | Between 6 months and 3 years | 8.0 |
| Bandyopad‐hyay 2011 34 | 17 | Australia | To explore understanding of Type 2 diabetes risk, risk reduction, management strategies, and attitudes and behaviour | Immigrant South Asian women recruited from GDM clinic after diagnosis | hGDM, age ≥18 years, Hindi‐, Bengali‐ or English‐speaking | Interviews (face‐to‐face) | At 6 weeks† | 8.0 |
| Nicklas 2011 28 | 25 | US | To identify barriers and facilitators to healthy lifestyle changes, and approaches to facilitate participation in interventions | Recruited through flyers and internet postings | hGDM within 7 years, age 18–50 years, English‐speaking, not since developed Type 2 diabetes | Interviews (telephone) and focus groups | Within 7 years | 8.5 |
| Gaudreau 2012 40 | 7 | Canada | To understand cultural factors contributing to maintenance of health behaviours encouraged during GDM pregnancy | Recruited by general informants contacts | hGDM within 2–10 years, age ≥18 years, Algonquin peoples, GDM/healthcare in Algonquin community, not breastfeeding or pregnant | Ethnography (observations and interviews) | Between 2 and 10 years | 8.5 |
| Hjelm 2012 21 | 14 | Sweden | To explore beliefs about health, illness and healthcare and study their influence on self‐care and care seeking | Consecutive sampling (women born in the Middle East living in Sweden recruited by staff at hospital‐based specialist clinic) | hGDM, age ≥16 years | Interviews (face‐to‐face) | At 3 and 14 months† | 9.5 |
| Jones 2012 35 | 17 | US | To describe knowledge, perceptions and self‐efficacy beliefs related to preventing cardiometabolic disease | Purposeful and snowball sampling (through fliers distributed by tribal health system care staff) | hGDM, self‐identify as American Indian, age 19–45 years, not pregnant or within 6 weeks postpartum (including 3 with Type 2 diabetes) | Interviews (not specified) | NR | 8.0 |
| Dasgupta 2013 22 | 29 | Canada | To identify factors that could enhance participation and engagement in a Type 2 diabetes prevention program | Recruited from GDM clinic via letter from physician (structured recruitment strategy) | hGDM, English‐ or French‐speaking, not pregnant or since developed Type 2 diabetes | Focus groups | Within 5 years | 9.0 |
| Lie 2013 32 | 35 | UK | To explore views on postnatal lifestyle change to prevent Type 2 diabetes to inform development of intervention approaches | Purposive then theoretical sampling (diabetes obstetric service contacted by clinic staff while attending appointments or from hospital records) | hGDM within 2 years, English‐speaking, age ≥16 years, successful pregnancy outcome, received antenatal care at specified sites, able to consent | Interviews (face‐to‐face) | Within 2 years then between 12 and 18 months later | 8.5 |
| Abraham 2014 33 | 10 | US | To explore lived experiences of women in rural communities with GDM | Purposive and snowball sampling (via obstetric and healthcare providers) | hGDM within 5 years, age ≥18 years, residence in a county eligible for rural community grants, not since developed Type 2 diabetes | Interviews (face‐to‐face and telephone) | Between 2 and 5 years | 8.0 |
| Morrison 2014 39 | 393 | Australia | To describe reflections on the experience of GDM‐pregnancy | Australian women recruited from the NDSS database for cross sectional survey by mailout | hGDM within 3 years, age ≥18 years at time of registration, not residing in a Queensland postcode‡ | Open‐ended survey | At 3 years | 7.0 |
| Jones 2015 23 | 26 | USA | To elicit women's perspectives on cardiometabolic risk reduction behaviours to inform the development of a postpartum lifestyle modification intervention | Contact study team after advertising study through fliers and business card distribution at the CNDH | hGDM within 10 years, self‐identify as American Indian, age 19–45 years, healthcare through CNDH | Interviews (face‐to‐face and telephone) and focus groups | Within 10 years (1 or 2 interviews) | 8.5 |
| O'Dea 2015 31 | 17 | Ireland | To evaluate a lifestyle intervention programme (give context to quantitative findings) | Women identified from the Atlantic DIP research database and hospital pregnancy service contacted by letters and telephone | hGDM within 1–3 years, English‐speaking, not pregnant or since developed Type 2 diabetes (randomized to the trial intervention arm) | Interviews (face‐to‐face) | Between 1 and 3 years | 7.5 |
| Tang 2014 26 | 23 | USA | To explore Type 2 diabetes risk perception and motivators and barriers to preventive health behaviours, to inform intervention approaches | Purposive sampling (African American, Hispanic, non‐Hispanic White women recruited from hospital‐affiliated academic clinics via telephone call from researcher or response to flyer) | hGDM within 1 year, English‐ or Spanish‐speaking, no pre‐existing diabetes or since developed Type 2 diabetes | Interviews (face‐to‐face) | Within 1 year | 8.5 |
| Lim 2017 27 | 165 | Australia | To explore the acceptability of a diabetes prevention programme and compare the characteristics associated with programme engagement | Women enrolled in the MAGDA trial | hGDM in most recent pregnancy, English‐speaking, not pregnant, with pre‐existing Type 2 diabetes or other severe illness | Interviews (face‐to‐face and telephone) | NR (1 or 2 interviews) | 8.5 |
| Pennington 2017 38 | 16 | Australia | To investigate factors influencing engagement with diabetes preventative care (barriers and enablers), the GP's role in care | Purposive sampling (approached or advertisements at general practices and MCHN centres) | hGDM | Interviews (face‐to‐face and telephone) | NR | 8.5 |
| Svensson 2017 25 | 5 | Denmark | To examine the experience of transition from a GDM‐affected pregnancy to postpartum | Random sampling (sent invitation letters via the hospital patient registry and telephoned) | hGDM, recently delivered at the hospital | Interviews (face‐to‐face) | Between 3 and 5 months | 8.0 |
| Zulfiqar 2017 29 | 23 | Australia | To explore barriers and facilitators to following long‐term healthy lifestyle recommendations, and whether there were differences between overseas‐born‐ and Australian‐born‐women | Women managed by a hospital DIP Service who attended a GDM‐related health education programme | hGDM, English‐speaking, live singleton delivery, not pregnant or since developed Type 2 diabetes | Interviews (face‐to‐face) | More than 3 years | 8.5 |
CASP, Critical Appraisal Skills Programme (score out of 10); CNDH, Chickasaw Nation Department of Health; DIP, Diabetes in Pregnancy; GDM, gestational diabetes; GP, general practitioner; hGDM, history of gestational diabetes; MAGDA, Mothers After Gestational Diabetes in Australia, MHCN, maternal and child health nurse centres; NDSS, National Diabetes Service Scheme; NR, not reported; PA, physical activity.
* reference to/since gestational diabetes‐affected pregnancy (studies collected data once postpartum unless otherwise specified); †Plus 1 during pregnancy; ‡Due to a concurrent study.