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- Title
A theoretical model of contraceptive decision‐making and behaviour in diabetes: A qualitative application of the Health Belief Model.
- Authors
Johnson, Emily; DeJonckheere, Melissa; Oliverio, Andrea L.; Brown, Kathryn S.; Van Sparrentak, Murphy; Wu, Justine P.
- Abstract
Aim: People with diabetes have contraceptive needs that have been inadequately addressed. The aim of this qualitative study was to develop a theoretical model that reflects contraceptive decision‐making and behaviour in the setting of diabetes mellitus. Methods: We conducted semi‐structured, qualitative interviews of 17 women with type 1 or type 2 diabetes from Michigan, USA. Participants were recruited from a diabetes registry and local clinics. We adapted domains from the Health Belief Model (HBM) and applied reproductive justice principles to inform the qualitative data collection and analysis. Using an iterative coding template, we advanced from descriptive to theoretical codes, compared codes across characteristics of interest (e.g. diabetes type), and synthesized the theoretical codes and their relationships in an explanatory model. Results: The final model included the following constructs and themes: perceived barriers and benefits to contraceptive use (effects on blood sugar, risk of diabetes‐related complications, improved quality of life); perceived seriousness of pregnancy (harm to self, harm to foetus or baby); perceived susceptibility to pregnancy risks (diabetes is a 'high risk' state); external cues to action (one‐size‐fits‐all/anxiety‐provoking counselling vs. personalized/trust‐based counselling); internal cues to action (self‐perceived 'sickness'); self‐efficacy (reproductive self‐efficacy, contraceptive self‐efficacy); and modifying factors (perceptions of biased counselling based upon one's age, race or severity of disease). Conclusions: This novel adaptation of the HBM highlights the need for condition‐specific and person‐centred contraceptive counselling for those with diabetes.
- Subjects
MICHIGAN; HEALTH Belief Model; CONTRACEPTION; RESEARCH methodology; DIABETES; INTERVIEWING; BLOOD sugar; RISK assessment; DECISION making; HEALTH behavior; QUALITY of life; COST effectiveness; REPRODUCTIVE health; CONTRACEPTIVE drugs
- Publication
Diabetic Medicine, 2021, Vol 38, Issue 6, p1
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.14434