UCLA

The treatment of gestational diabetes mellitus (GDM) is currently undergoing assessment and revisions to improve pregnancy outcomes of GDM women. Previous studies focused on finding new strategies to decrease the incidence of GDM complications, however, there is insufficient evidence supporting strategies that enhance adherence to healthy lifestyle behaviors among women with GDM.

The purpose of this pre-test and post-test comparative experimental study (control vs. intervention) is to evaluate the effectiveness of a health education intervention on improving gestational diabetes women’s self-efficacy for adherence to healthy behaviors and ability for adherence to healthy behaviors. This study was conducted at Sultan Qaboos University Hospital between October 2016 and January 2017, among Omani women with GDM. Standard prenatal care was received by the control group, the intervention group received an additional health education session and a biweekly text messages for 4 weeks. Different self-efficacy enhancing strategies (e.g., motivational messages, role modeling, goal setting, and mastery experiences) were used to encourage women to maintain the recommended healthy behaviors.

Total of ninety GDM women completed both the pre-test and post-test. At baseline, no significant variances between study groups in relation to self-efficacy for adherence to healthy behaviors (t=1.14, p= .62) and adherence to healthy behaviors (t= - .80, p= .23) were found. At post-test, the intervention group reported significant improvement in the self-efficacy score (M= 9.89, SD= 19.58) in comparison to the control group (M= - 1.84, SD= 17. 58); t (88)= -2.99, p< .001). The improvement in self-efficacy for adherence to healthy behaviors was not a significant predictor for the improvement in adherence to healthy behaviors (B= .01, SE= .01, p= .08), controlling for the group. However, it was found that the improvement in self-efficacy for adherence to healthy behaviors partially mediates the relationship between the group assignment and the improvement in adherence to healthy behaviors. While physical limitations was the primary barrier for adherence to healthy behaviors, participants’ concern of GDM-related complications was the top motivator for adherence to healthy behaviors.

The findings from this study demonstrate that the health education intervention significantly improved gestational diabetes women’s self-efficacy for adherence to healthy behaviors and their ability for adherence to healthy behaviors. Improved adherence to healthy behaviors should reflect in decreased incidence of GDM-related complications. Future examination of the data is planned that will study its effect on improving pregnancy outcomes of Omani pregnant women with gestational diabetes. Upcoming research should focus on preventing incidence of gestational diabetes through lifestyle modification interventions that incorporates self-efficacy as motivational strategy to improve adherence to healthy behaviors.