{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T12:40:28Z","timestamp":1736340028715,"version":"3.32.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"RTP scholarship University of Newcastle"},{"name":"Australian Government Department of Health and Aged Care\u2019s Rural Health Multidisciplinary Program Funding"},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["L3, APP2009340"],"award-info":[{"award-number":["L3, APP2009340"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Women and people diagnosed with diabetes in pregnancy, are recommended to have frequent monitoring and careful management for optimal pregnancy outcomes. This health care management should be supported by a multidisciplinary healthcare team. For individuals living in rural areas, there are increased barriers to healthcare access, with subsequent worse health outcomes compared to those in metropolitan regions. Despite this, there remains a lack of research into the experiences of healthcare delivery for rural women and people with diabetes in pregnancy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Survey invitations were sent via the National Diabetes Services Scheme email list. The survey included multiple choice and open-ended questions. Responses from the open-ended question asking participants the changes they would want made to their care delivery were interpreted using qualitative content analysis. Responses were separated into metropolitan and rural categories using the Modified Monash Model criteria.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>There were 668 survey responses, with 409 responding to the open-ended qualitative survey question\/s. 71.6% of respondents were metropolitan and 27.6% lived rurally. A total of 31 codes were established from the open-ended responses, with the five overarching themes of \u2018quality of care\u2019, \u2018practice &amp; communication\u2019, \u2018individual\u2019s experience\u2019, \u2018access\u2019 and \u2018burden of care\u2019 identified. The most frequently occurring codes irrespective of location included education or information (n\u2009=\u200945), frequency and timeliness of care (n\u2009=\u200942), no changes (n\u2009=\u200942) and improved health professional communication (n\u2009=\u200940). Local care options was the only code with more rural quotes compared to metropolitan.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The most frequently occurring codes had strong representation from metropolitan and rural respondents, indicating that those with previous diabetes in pregnancy had similar priorities for changes in their healthcare delivery regardless of location. Rural respondents identifying local care options as a priority for change is likely indicative of the rural healthcare landscape with limited access to care options. Recommendations from this study supported by previous research include focusing on improving health professional communication both with women and people with diabetes in pregnancy and with other relevant professionals. Recommendations for rural locations should focus on improving local care options whilst considering resource limitation, such as telehealth clinics.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12884-024-07093-8","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T11:19:42Z","timestamp":1736335182000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the experiences of women and people with diabetes in pregnancy in metropolitan and rural Australia: a national survey"],"prefix":"10.1186","volume":"25","author":[{"given":"Ellen","family":"Payne","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Heaney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"Collins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Rollo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leanne J.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"issue":"Supplement1","key":"7093_CR1","first-page":"S254","volume":"46","author":"NA ElSayed","year":"2022","unstructured":"ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 15. Management of diabetes in pregnancy: standards of Care in Diabetes\u20142023. Diabetes Care. 2022;46(Supplement1):S254\u201366.","journal-title":"Diabetes Care"},{"key":"7093_CR2","unstructured":"Queensland Clinical Guidelines. Gestational diabetes mellitus (GDM). Queensland Queensland Health; 2021."},{"key":"7093_CR3","unstructured":"Government of South Australia. In: Wellbeing DH, editor. Diabetes Mellitus and Gestational Diabetes. Government of South Australia; 2019."},{"key":"7093_CR4","doi-asserted-by":"publisher","first-page":"e067946","DOI":"10.1136\/bmj-2021-067946","volume":"377","author":"W Ye","year":"2022","unstructured":"Ye W, Luo C, Huang J, Li C, Liu Z, Liu F. Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2022;377:e067946.","journal-title":"BMJ"},{"key":"7093_CR5","unstructured":"Diabetes Australia. Position Statement: gestational diabetes in Australia. Diabetes Australia; 2020. pp. 1\u20139."},{"issue":"6","key":"7093_CR6","doi-asserted-by":"publisher","first-page":"E18","DOI":"10.1111\/ajo.13265","volume":"60","author":"VL Rudland","year":"2020","unstructured":"Rudland VL, Price SAL, Hughes R, Barrett HL, Lagstrom J, Porter C, et al. ADIPS 2020 guideline for pre-existing diabetes and pregnancy. Aust N Z J Obstet Gynaecol. 2020;60(6):E18\u201352.","journal-title":"Aust N Z J Obstet Gynaecol"},{"issue":"1","key":"7093_CR7","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s12884-020-2745-1","volume":"20","author":"L Craig","year":"2020","unstructured":"Craig L, Sims R, Glasziou P, Thomas R. Women\u2019s experiences of a diagnosis of gestational diabetes mellitus: a systematic review. BMC Pregnancy Childbirth. 2020;20(1):76.","journal-title":"BMC Pregnancy Childbirth"},{"key":"7093_CR8","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.midw.2016.06.019","volume":"40","author":"CR Draffin","year":"2016","unstructured":"Draffin CR, Alderdice FA, McCance DR, Maresh M, Harper MR, McSorley O, et al. Exploring the needs, concerns and knowledge of women diagnosed with gestational diabetes: a qualitative study. Midwifery. 2016;40:141\u20137.","journal-title":"Midwifery"},{"issue":"2","key":"7093_CR9","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1111\/ajo.13530","volume":"62","author":"K Calvert","year":"2022","unstructured":"Calvert K, Leathersich S, Howat P, Van Der Wal S. Time to make some noise about a quiet revolution. Aust N Z J Obstet Gynaecol. 2022;62(2):336\u20138.","journal-title":"Aust N Z J Obstet Gynaecol"},{"issue":"1","key":"7093_CR10","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1111\/ajo.13746","volume":"64","author":"L Jones","year":"2024","unstructured":"Jones L, Carroll R, Parker G, Steers D, Ormandy J, Filoche S. Developing a transgender and non-binary inclusive obstetrics and gynaecology undergraduate medical curriculum in Aotearoa\/New Zealand: where are we at, and where do we need to be? Aust N Z J Obstet Gynaecol. 2024;64(1):15\u20138.","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"7093_CR11","unstructured":"Australian Health Ministers\u2019 Advisory Council Rural Health Standing Committee. National Strategic Framework for Rural and Remote Health Canberra; Australia Department of Health, Australian Government 2012."},{"issue":"6","key":"7093_CR12","doi-asserted-by":"publisher","first-page":"1590","DOI":"10.2337\/dc13-2717","volume":"37","author":"DS Feig","year":"2014","unstructured":"Feig DS, Hwee J, Shah BR, Booth GL, Bierman AS, Lipscombe LL. Trends in incidence of diabetes in pregnancy and serious perinatal outcomes: a large, Population-based study in Ontario, Canada, 1996\u20132010. Diabetes Care. 2014;37(6):1590\u20136.","journal-title":"Diabetes Care"},{"key":"7093_CR13","doi-asserted-by":"crossref","unstructured":"Venkatesh KK, Huang X, Cameron NA, Petito LC, Joseph J, Landon MB et al. Rural\u2013urban disparities in pregestational and gestational diabetes in pregnancy: Serial, cross-sectional analysis of over 12 million pregnancies. BJOG: Int J Obstet Gynecol. 2023;n\/a(n\/a).","DOI":"10.1111\/1471-0528.17587"},{"issue":"3","key":"7093_CR14","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1111\/ajo.13295","volume":"61","author":"RL Williamson","year":"2021","unstructured":"Williamson RL, McCarthy EA, Oats JJ, Churilov L, Lappas M, Shub A. Obstetric and perinatal outcomes for women with pre-existing diabetes in rural compared to metropolitan settings in Victoria, Australia. Aust N Z J Obstet Gynaecol. 2021;61(3):373\u20139.","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"7093_CR15","unstructured":"Alliance NRH. Evidence base for additional investment in rural health in Australia. National Rural Health Alliance; 2023."},{"issue":"1","key":"7093_CR16","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.wombi.2013.02.001","volume":"27","author":"H Hoang","year":"2014","unstructured":"Hoang H, Le Q, Terry D. Women\u2019s access needs in maternity care in rural Tasmania, Australia: a mixed methods study. Women Birth. 2014;27(1):9\u201314.","journal-title":"Women Birth"},{"issue":"6","key":"7093_CR17","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1111\/ajr.12292","volume":"24","author":"L Ge","year":"2016","unstructured":"Ge L, Wikby K, Rask M. Is gestational diabetes a severe illness?\u2019 Exploring beliefs and self-care behaviour among women with gestational diabetes living in a rural area of the south east of China. Aust J Rural Health. 2016;24(6):378\u201384.","journal-title":"Aust J Rural Health"},{"issue":"4","key":"7093_CR18","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1097\/NMC.0000000000000047","volume":"39","author":"K Abraham","year":"2014","unstructured":"Abraham K, Wilk N. Living with gestational diabetes in a rural community. MCN Am J Matern Child Nurs. 2014;39(4):239\u201345.","journal-title":"MCN Am J Matern Child Nurs"},{"issue":"2","key":"7093_CR19","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1016\/j.midw.2007.01.016","volume":"25","author":"R King","year":"2009","unstructured":"King R, Wellard S. Juggling type 1 diabetes and pregnancy in rural Australia. Midwifery. 2009;25(2):126\u201333.","journal-title":"Midwifery"},{"issue":"1","key":"7093_CR20","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.wombi.2013.10.001","volume":"27","author":"MK Morrison","year":"2014","unstructured":"Morrison MK, Lowe JM, Collins CE. Australian women\u2019s experiences of living with gestational diabetes. Women Birth. 2014;27(1):52\u20137.","journal-title":"Women Birth"},{"key":"7093_CR21","doi-asserted-by":"publisher","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","volume":"95","author":"PA Harris","year":"2019","unstructured":"Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O\u2019Neal L, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inf. 2019;95:103208.","journal-title":"J Biomed Inf"},{"issue":"2","key":"7093_CR22","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","volume":"42","author":"PA Harris","year":"2009","unstructured":"Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inf. 2009;42(2):377\u201381.","journal-title":"J Biomed Inf"},{"key":"7093_CR23","unstructured":"Diabetes Australia. About the NDSS: Diabetes Australia. 2023 [Available from: https:\/\/www.diabetesaustralia.com.au\/resources\/ndss\/"},{"key":"7093_CR24","unstructured":"Australian Government Department of Health. Modified Monash Model: Australian Government Department of Health,; 2020 [cited 2020 August 24]. Available from: https:\/\/www.health.gov.au\/health-workforce\/health-workforce-classifications\/modified-monash-model"},{"issue":"1","key":"7093_CR25","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1002\/nur.20362","volume":"33","author":"M Sandelowski","year":"2010","unstructured":"Sandelowski M. What\u2019s in a name? Qualitative description revisited. Res Nurs Health. 2010;33(1):77\u201384.","journal-title":"Res Nurs Health"},{"issue":"3","key":"7093_CR26","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1111\/nhs.12048","volume":"15","author":"M Vaismoradi","year":"2013","unstructured":"Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013;15(3):398\u2013405.","journal-title":"Nurs Health Sci"},{"issue":"1","key":"7093_CR27","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1186\/s12884-023-06130-2","volume":"23","author":"H Pelak","year":"2023","unstructured":"Pelak H, Dahlen HG, Keedle H. A content analysis of women\u2019s experiences of different models of maternity care: the birth experience study (BESt). BMC Pregnancy Childbirth. 2023;23(1):864.","journal-title":"BMC Pregnancy Childbirth"},{"key":"7093_CR28","unstructured":"Schreier M, Content Analysis Q. London2019. Available from: https:\/\/methods-sagepub-com-christuniversity.knimbus.com\/foundations\/qualitative-content-analysis"},{"key":"7093_CR29","unstructured":"Lumivero. NVivo Pro 12: Lumivero; 2017 [."},{"issue":"6","key":"7093_CR30","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1016\/j.midw.2012.05.013","volume":"29","author":"M Carolan","year":"2013","unstructured":"Carolan M. Women\u2019s experiences of gestational diabetes self-management: a qualitative study. Midwifery. 2013;29(6):637\u201345.","journal-title":"Midwifery"},{"key":"7093_CR31","unstructured":"Australian Institute of Health and Welfare. Rural & remote health. In: AIHW, editor. Canberra2022."},{"issue":"3","key":"7093_CR32","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1111\/j.1471-6712.2009.00735.x","volume":"24","author":"M Persson","year":"2010","unstructured":"Persson M, Winkvist A, Mogren I. From stun to gradual balance\u2019--women\u2019s experiences of living with gestational diabetes mellitus. Scand J Caring Sci. 2010;24(3):454\u201362.","journal-title":"Scand J Caring Sci"},{"key":"7093_CR33","doi-asserted-by":"crossref","unstructured":"Parsons J, Sparrow K, Ismail K, Hunt K, Rogers H, Forbes A. Experiences of gestational diabetes and gestational diabetes care: a focus group and interview study. BMC Pregnancy and Childbirth. 2018;18(1):25.","DOI":"10.1186\/s12884-018-1657-9"},{"key":"7093_CR34","doi-asserted-by":"crossref","unstructured":"Simmons D, Cheung NW, McIntyre HD, Flack JR, Lagstrom J, Bond D et al. The ADIPS pilot National Diabetes in Pregnancy Audit Project. Australian & New Zealand Journal of Obstetrics & Gynaecology. 2007;47(3):198\u2013206.","DOI":"10.1111\/j.1479-828X.2007.00718.x"}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-024-07093-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12884-024-07093-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-024-07093-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T12:05:04Z","timestamp":1736337904000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-024-07093-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,8]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["7093"],"URL":"https:\/\/doi.org\/10.1186\/s12884-024-07093-8","relation":{},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,8]]},"assertion":[{"value":"10 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The University of Newcastle\u2019s Human Research Ethics Committee approved this study (H-2021-0425). Informed consent was obtained at the beginning of the survey with participants asked if they were willing to participate in the survey. Participants were informed that if they responded \u2018yes\u2019 to this question they were indicating they had read the Participant Information Statement embedded at the beginning of the survey and that they were consenting to participate in the research project. Participant data would not be used if they did not press \u201csubmit\u201d on completion of the survey. All methods were conducted in accordance with the ethical principles outlined in the World Medical Association\u2019s Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16"}}