Table 1.
Focus group discussion and in-depth interview guide.
| Interview questions and probes | |
| IDIs with women with prior GDM | Please tell us about yourself in brief. Probes: Demographic details, family structure, resources, distance to hospital, etc. |
| Current diagnosis and management of GDM | |
| What do you know about Gestational Diabetes Mellitus? Probe signs/symptoms/diagnosis |
|
| Please tell me about your experience of managing gestational diabetes? How was your experience with the hospital staff? Probe: Support from family members, friends, relatives, any other, management strategies for GDM worked for you? What information do you have now, that would have been helpful at the beginning? |
|
| What information have you received from the hospital or the doctor? Do the discussions, with doctors involve postpartum care? Probe: Healthy lifestyle postpartum, periodic testing, breastfeeding, contraception etc. |
|
| Postpartum screening | |
| Barriers and facilitators women may face in returning for an OGTT in the hospital in the postpartum period Probe: Process of consultation; convenience; attitude/behavior of the staff |
|
| Physical activity and healthy diet | |
| How important is it to perform physical activity/exercise after childbirth according to you? How difficult/easy was it to find the time in your daily schedule? |
|
| Have you done physical activity/exercise after the birth of your child? How much time did you spend on it? Probe: Was it guided by your doctor/other support staff at hospital? What was the reaction/opinion of your family members? What type of support did you receive from family members? |
|
| What kind of activities do you think should be avoided after delivery? | |
| Nutritious food is required after childbirth. What type of food have you eaten after childbirth? Probe: Was it suggested by the doctors/dietician at hospital/any other? |
|
| Intervention | |
| Do you think women with GDM need information for awareness about GDM? Probe: Please elaborate and give reasons |
|
| What are the different ways that we can adopt to engage these women for our program? Probe: Group sessions, individual sessions, SMS, phone calls, pamphlets, pictorial booklet, or any other |
|
| Explanation of intervention proposed and timelines | |
| Do you think such an intervention will be beneficial for women with GDM? | |
| Please suggest the best way you feel this intervention can be delivered. Probe: At the hospital/mode of delivery/frequency of contact |
|
| Do you have any suggestions on how to keep women engaged in year 2 and 3? | |
| What are some ways to utilize the potential support from peers/family members to encourage sustainable behavior change? | |
| Explanation of content of sessions | |
| Who do you think will be the best person to deliver this intervention if this was to become a usual practice? Why? Probe: doctor/nurse/counselor/MSW |
|
| What are the major challenges you expect during the delivery of the intervention? What may be some measures to overcome these? |
|
| Do you feel this intervention should be a part of the usual care for GDM? | |
| How big should a group be? Why? Logistics of group sessions |
|
| How long should one group session last? | |
| Which days do you think are good for group sessions? What time? Why? | |
| What is an appropriate place to conduct these sessions? Why this place? Probe: Do you think we can take support from peers/family members of women? How can we engage their family members? |
|
| Intrapregnancy session | |
| Please provide feedback on the pamphlet. Do you think this will be useful? What information can be included/excluded? | |
| IDIs with Health Care Providers | Please tell us about yourself. How long you have been associated with this institution? Probe: Educational background, work experience, number of years and nature of work |
| Current diagnosis and management of GDM | |
| Please tell us about GDM. What are its sign and symptoms? | |
| What are the current practices in your hospital related to GDM? Probe: Diagnosis and management practices, referral practices, and follow up |
|
| How many patients of GDM come to the unit, and how many get treated? | |
| In your opinion, what are the various factors that encouraged and discouraged individuals in seeking treatment/follow up? Probe: Knowledge. support, socio-economic status, financial reasons, distance, taking care of children, any other |
|
| Lifestyle/behavior modifications are important for women with GDM. Please comment. Probe: Barriers and challenges |
|
| Generally, what practices does this hospital follow to support these women for lifestyle/behavior changes? | |
| Postpartum screening | |
| What are the current practices related to postpartum screening of GDM cases? How is advice communicated and how much importance is it given during the interaction? Probe: Advantages and disadvantages |
|
| According to you what are the potential barriers/facilitators in continuing the treatment? Probe: Process of consultation, lab test, collection of results and re-consultation with doctor? |
|
| Do the women adhere to the visit schedule (postpartum OGTT)? Do they come back to see the doctor as advised? |
|
| What should be our strategy if we plan to reengage with women after delivery? Probe: Meeting them at the time of delivery, during hospitalization, contacting family, etc. |
|
| Intervention | |
| Do you think women with GDM in your hospital need some information to increase awareness, and improve their outlook toward GDM & its treatment? Probe: Please elaborate and give reasons. |
|
| What are the different ways that we can adopt to engage these women for our program? Probe: Group sessions, individual sessions, any other, group size, days, frequency, time |
|
| In your opinion who should be involved to provide such information with in the hospital? Probe: ANMs, Doctors, Nurse, Counselor/MSW etc.? And who else? |
|
| According to you, do these people require some training? Probe: Duration, content, frequency, place for such training |
|
| According to you, do we need to provide incentives to participants for their participation? If so, what type of incentives? Give details. |
|
| How can we engage the peers/family members of women for this program? | |
| How can this program be sustained? Please suggest in what ways we can monitor program delivery? Probe: Involvement of peers/family members of women, any other? |
|
| Overall, what are the major challenges you expect us to encounter while delivering the intervention program? Can you suggest measures to overcome these challenges? |
|
| FGDs with women with prior GDM | Please tell us about yourself in brief. At home, who takes the dietary decisions? Probe: Demographic details, family structure, resources, distance to hospital, etc. |
| Current diagnosis and management of GDM | |
| What do you know about Gestational Diabetes Mellitus? Probe: signs/symptoms/diagnosis |
|
| Please tell me about your experience of managing gestational diabetes? Probe: Support from family members, friends, relatives, any other |
|
| Generally, what kind of difficulties did you face in managing your gestational diabetes? -What management strategies (ways of dealing with your diabetes) worked for you? -What advice would you give to someone who was newly diagnosed with GDM? -What information do you have now that would have been helpful at the beginning? |
|
| Can you tell me a little about the information you received from the hospital or the doctor? Do the discussions with doctors involves postpartum care also? Probe: maintenance of healthy lifestyle postpartum, periodic testing, breastfeeding, contraception, etc. |
|
| Postpartum screening | |
| What are various barriers and facilitators that women like you may face in returning for an OGTT in hospital in the postpartum period? Probe: Process of consultation, lab test, collection of results and re-consultation with doctor, related costs, distance, convenience, time, mode of travel, attitude, and behavior of the staff |
|
| Physical activity and healthy diet | |
| How important is it to do physical activity/exercise after childbirth? Give details. | |
| Have you done physical activity/exercise after the birth of your child? How much time did you spend on it? Probe: -Was it guided by your doctor/other support staff at hospital? -What was the reaction/opinion of your family members? -What type of support did you receive from family members? -How difficult/easy was it to find the time in your daily schedule? |
|
| In your opinion, what kind of physical activities/exercises should be avoided after delivery? | |
| Nutritious food is required after childbirth. Please give your opinion on this. Generally, what type of food have you been eating after childbirth? Probe: Was it suggested by the doctors/dietician at hospital/family members/any other? Have you had any vitamins or iron supplements? |
|
| Intervention | |
| Do you think women with GDM in your hospital need some information to increase awareness, and improve their outlook toward GDM and its treatment? Probe: Please elaborate and give reasons. |
|
| What are the different ways that we can adopt to engage these women in our program? Probe: Group sessions, individual sessions, SMS, phone calls, pamphlets, pictorial booklet, or any other |
|
| Explanation of intervention proposed and timelines | |
| Do you think such an intervention will be beneficial for women with GDM? | |
| Please suggest the best way you feel this intervention can be delivered. Probe: at the hospital/mode of delivery/frequency of contact |
|
| Do you have any suggestions on how to keep women engaged with us in year 2 and 3? | |
| What are the ways to utilize the potential support from peers/family members to encourage sustainable behavior change? | |
| Explanation of content of sessions | |
| Who do you think will be the best person to deliver this intervention if this was to become a usual practice? Why do you feel so? Probe: doctor/nurse/counselor/MSW |
|
| What are the major challenges you expect women to encounter while this intervention is being delivered? Can you suggest measures to overcome these? |
|
| Do you feel this intervention should be a part of the usual care for GDM? | |
| Logistics of group sessions | |
| How big should a group be? Why do you think this is an appropriate size? | |
| How much time should a group session last? | |
| Which days do you think are good for group sessions, and what time do you think will be the best to conduct group sessions? Why? | |
| What would be an appropriate place to conduct these sessions? Why do you suggest this place? |
|
| Do you think we can take support from peers/family members of women? Probe: how can we engage their family members |
|
| Intra pregnancy session (Show pamphlet) | |
| Please provide feedback on the pamphlet. Do you think this will be useful? What information can be included/excluded? |