Table 2. Summary of the themes and participants’ agreement with whether the suggestion cards will support healthy diet and physical activity.
| Theme | Overall response | Illustrative quotations |
|---|---|---|
| Information and understanding | Suggestion card 1: agree | • “I think the more information a person can have, the more able they are to make an informed decision, and I think that’s, especially as a mum, what you want.” [P4, not healthier] • “I think people know about healthy diet and exercising and they know that’s good for you and good for your weight but whether people can do it might be another thing.” [P2, healthier, unsupported] • “I don’t think that’s [card 2] as necessary, because I feel like that’s widely available, and I know that. But in terms of the link to diabetes [card 1], I didn’t know that.” [P5, not healthier] |
| Card 2: mixed | ||
| Improving diet | Card 6: agree | • “The diet I was given to follow during pregnancy, bits of it felt very counter to what I understood to be healthy… I understood for the purposes of really stabilising my blood sugar that was important to do but… My vision of what a healthy long-term diet are don’t include most of those features… I suppose that would be quite useful if there was some sort of follow-up information, ‘Okay, you’ve done this, now you’re going to rebound a bit and we’re not asking you to keep it like this but it would be a good idea to…’, you know, ‘These ones are worth following, these ones aren’t.’ Maybe that exists but I don’t think I’ve seen it.” [P6, healthier, supported] • “If you have a clean track of what you want to eat and what are the things that add up your calories and what other things are good for you to control your diabetes, like the sugar levels. I think that can help a lot.” [P7, healthier, supported] |
| Improving physical activity | Card 5: agree | • “Like how to exercise around the home, because it’s really difficult trying to work out when you’re going to fit everything in, especially when you’ve got a small person that generates more washing than you could ever imagine…” [P8, not healthier] • “Having a baby carrier… you can keep an eye on them and they are happy because they’re [across your chest]. But also it gives you both your hands free to do stuff. Also it is exercise because you’re carrying them around and they’re getting heavier and heavier. Just make sure you get a good one that supports your back.” [P9, healthier, supported] • “Just a bit of a pointer in where to go and who to go to and what also would fit into a family life in terms of finance and childcare, and potentially meeting up with other mums or other people who’ve had diabetes as well.” [P10, healthier, supported] |
| Card 7: agree | ||
| Family | Card 3: mixed | • “…Sometimes [my children] won’t agree to what you give… there’s green food–‘I don’t want’, they want some kind of pizza or burger all those things but still I somehow try to convince her with this kind of food.” [P7, healthier, supported] • “We both [her and her husband] did a lot of research… we are much more health-conscious and we try to exercise more, so I think we’ve both changed our lifestyle, and it carries on as well.” [P11, healthier, unsupported] • The children “don’t struggle with blood sugars, they don’t struggle with not being able to get out and get fresh air.” [P10, healthier, supported] |
| Card 4: mixed | ||
| Money | Card 9: mixed | • “I mean it’s always good to know about how to save money but I just don’t think people don’t go on a healthy diet because of money problems.” [P2, healthier, unsupported] • “I don’t think there’s much useful guidance about maintaining that kind of healthy diabetes-friendly diet on a budget actually. A lot of healthy meals tend to be focused on things like lasagnes and stuff like that, like big batch cook things that aren’t necessarily the right thing for someone who is trying to like minimise diabetes risk to be eating.” [P12, healthier, unsupported] |
| Monitoring | Card 10: agree | • “It’s always nice to see your results to see some sort of benefits that you’ve been achieving, I think spurs you on.” [P13, healthier, supported] • “Apart from contacting my doctor to get a HbA1c test every year, no one’s contacted me to say, ’Have you made any lifestyle changes, how you getting on?’ So, it’s almost like you’re just left to get on then afterwards.” [P14, healthier, supported] |
| Sustainability | Card 8: agree | • “I think that would be really useful because I know a lot of people would perhaps make the change and then slip back into bad habits.” [P15, healthier, unsupported] • “Because people lose motivation quite quickly, they have the best intentions, and then… I think that’s probably where support groups that motivate one another would help.” [P14, healthier, supported] |
| Delivery of support or interventions | NA | • “I think it needs to be someone that’s personable, because I think from my experience, sometimes when you go to the hospital you get really nice consultants and sometimes you don’t… just needs to be someone that can be relatable and friendly and isn’t going to come across hostile or judgey, it is just here if you need a chat sort of thing.” [P16, healthier, unsupported] • “That is all while you are pregnant but then maybe afterwards you don’t get that side to carry on… Like a little leaving parcel of like here’s a little pack of how to keep going with the good work you’ve done, and help you prevent it in the future and just make it clear that actually although it is gestational and it goes, it doesn’t mean you are rid forever.” [P16, healthier, unsupported] • “If somebody had said to me at that point, ‘You need to be eating this, this and this,’ I think I’d have probably cried”, and “I just think that rather than checking, so that people don’t feel like they’re being checked up on, because if you’ve been ill and you haven’t got out of the house, you don’t want to feel like you’re failing your child.” [P8, not healthier] • “Especially when you’re doing feedings… late night feeds or whatever, you can sit and have a look at your phone and get that support 24/7.” [P14, healthier, supported] |
Overall agreement is based on the authors’ interpretation of the responses. Not all participants were shown each card, and some did not comment or agreement was unclear. For each quote, we report the participant number, whether they were attempting healthier postpartum lifestyle or not (healthier/not healthier), and whether overall they felt supported to do this (supported/unsupported).
NA: not appropriate.