An exploratory mixed method assessment of low income, pregnant Hispanic women's understanding of gestational diabetes and dietary change

Objective: To describe and assess low income, healthy, pregnant Hispanic women's understanding of gestational diabetes (GDM) and willingness to change aspects of their diet. Design: One-on-one, in-person interviews conducted in Spanish with 94 women (primarily Mexican). Setting: Federal Qualified Community Health Center's prenatal clinic. Method: Exploratory two-phased mixed method with a survey of knowledge and attitudes towards gestational diabetes and dietary change, and interviews. In phase two, participants were shown a flyer with the amount of carbohydrates in tortillas and fruit juice in comparison to a candy bar and told of the importance of drinking one glass of water before each meal. Results: Interest in having a healthy baby was high for all participants. Review of a 24-hour dietary recall identified high consumption of carbohydrates and low intake of green and leafy vegetables and water. Family involvement, especially involvement of the husband, was central to almost all the participants' views about food purchase, preparation and consumption. In the phase two follow-up, most women tried to improve their water intake but no-one reported being able to decrease the number of tortillas eaten. Conclusion: The overall profile of attitudes, knowledge, diet and willingness to change aspects of a diet offers additional direction on how to counsel this patient group on ways to decrease risk of GDM. Given Hispanic women's elevated risk for GDM, small dietary changes presented in culturally relevant, straightforward messages about commonly eaten foods might result in improved health for the mother and the broader family.