{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:24:13Z","timestamp":1793139853102,"version":"4.5.0"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T00:00:00Z","timestamp":1698364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020400","name":"Clinical and Translational Science Center, Weill Cornell Medical College","doi-asserted-by":"publisher","award":["UL1 TR 002384"],"award-info":[{"award-number":["UL1 TR 002384"]}],"id":[{"id":"10.13039\/100020400","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007273","name":"Weill Cornell Medical College","doi-asserted-by":"publisher","award":["Primary Care Innovation Grant"],"award-info":[{"award-number":["Primary Care Innovation Grant"]}],"id":[{"id":"10.13039\/100007273","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007273","name":"Weill Cornell Medical College","doi-asserted-by":"publisher","award":["Primary Care Innovation Grant"],"award-info":[{"award-number":["Primary Care Innovation Grant"]}],"id":[{"id":"10.13039\/100007273","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007273","name":"Weill Cornell Medical College","doi-asserted-by":"publisher","award":["Fund for the Future Grant"],"award-info":[{"award-number":["Fund for the Future Grant"]}],"id":[{"id":"10.13039\/100007273","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43 TW009337"],"award-info":[{"award-number":["D43 TW009337"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006492","name":"Division of Intramural Research, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["AI129854"],"award-info":[{"award-number":["AI129854"]}],"id":[{"id":"10.13039\/100006492","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Bonnie Johnson Sacerdote Clinical Scholarship in Women\u2019s Health"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>The World Health Organization recommends all pregnant women receive screening for gestational diabetes (GDM) with a fasting oral glucose tolerance test (OGTT). However, very few women receive recommended screening in resource-limited countries like India. We implemented a community health worker (CHW)-delivered program to evaluate if home-based, CHW-delivered OGTT would increase GDM screening in a low-resource setting. We conducted a mixed methods study in two urban slum communities in Pune, India. CHWs were trained to deliver home-based, point-of-care fasting OGTT to women in their third trimester of pregnancy. The primary outcome was uptake of CHW-delivered OGTT. Secondary outcomes included GDM prevalence and linkage to GDM care. Individual interviews were conducted with purposively sampled pregnant women, CHWs, and local clinicians to assess barriers and facilitators of this approach. From October 2021-June 2022, 248 eligible pregnant women were identified. Of these, 223 (90%) accepted CHW-delivered OGTT and 31 (14%) were diagnosed with GDM. Thirty (97%) women diagnosed with GDM subsequently sought GDM care; only 10 (33%) received lifestyle counseling or pharmacologic therapy. Qualitative interviews indicated that CHW-delivered testing was considered highly acceptable as home-based testing saved time and was more convenient than clinic-based testing. Inconsistent clinical management of GDM was attributed to providers\u2019 lack of time to deliver counseling, and perceptions that low-income populations are not at risk for GDM. Convenience and trust in a CHW-delivered GDM screening program resulted in high access to gold-standard OGTT screening and identification of a high GDM prevalence among pregnant women in two urban slum communities. Appropriate linkage to care was limited by clinician time constraints and misperceptions of GDM risk. CHW-delivered GDM screening and counseling may improve health education and access to preventive healthcare, offloading busy public clinics in high-need, low-resource settings.<\/jats:p>","DOI":"10.1371\/journal.pgph.0001622","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T17:20:55Z","timestamp":1698427255000},"page":"e0001622","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["A community health worker-led program to improve access to gestational diabetes screening in urban slums of Pune, India: Results from a mixed methods study"],"prefix":"10.1371","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5422-2966","authenticated-orcid":true,"given":"Puja","family":"Chebrolu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Chalem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Ponticiello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Broderick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthi","family":"Vaidyanathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Lorenc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishali","family":"Kulkarni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashlesha","family":"Onawale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyoti S.","family":"Mathad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8451-2243","authenticated-orcid":true,"given":"Radhika","family":"Sundararajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,10,27]]},"reference":[{"issue":"6","key":"pgph.0001622.ref001","doi-asserted-by":"crossref","first-page":"701","DOI":"10.4103\/2230-8210.164031","article-title":"Gestational diabetes in India: Science and society","volume":"19","author":"A Mithal","year":"2015","journal-title":"Indian J Endocrinol Metab"},{"issue":"3","key":"pgph.0001622.ref002","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.diabres.2007.06.002","article-title":"Gestational diabetes and the incidence of diabetes in the 5 years following the index pregnancy in South Indian women","volume":"78","author":"GV Krishnaveni","year":"2007","journal-title":"Diabetes Res Clin Pract"},{"issue":"2","key":"pgph.0001622.ref003","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1089\/jwh.2020.8853","article-title":"Dysglycemia in Pregnancy and Maternal\/Fetal Outcomes","volume":"30","author":"CM Silva","year":"2021","journal-title":"J Womens Health (Larchmt)"},{"issue":"3","key":"pgph.0001622.ref004","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.diabres.2014.02.012","article-title":"Strategies for implementing the WHO diagnostic criteria and classification of hyperglycaemia first detected in pregnancy","volume":"103","author":"S Colagiuri","year":"2014","journal-title":"Diabetes Res Clin Pract"},{"issue":"1","key":"pgph.0001622.ref005","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1186\/s12884-017-1429-y","article-title":"Factors influencing timely initiation and completion of gestational diabetes mellitus screening and diagnosis\u2014a qualitative study from Tamil Nadu, India","volume":"17","author":"KK Nielsen","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"pgph.0001622.ref006","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1186\/s12913-021-06077-0","article-title":"Health care professionals\u2019 perspectives on screening and management of gestational diabetes mellitus in public hospitals of South India\u2014a qualitative study","volume":"21","author":"B Sahu","year":"2021","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pgph.0001622.ref007","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1186\/s12884-020-03115-3","article-title":"Magnitude of screening for gestational diabetes mellitus in an urban setting in Tanzania; 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