Misconceived expectations: Aboriginal women's experiences with gestational diabetes mellitus in the urban context of Winnipeg, Manitoba
Bibliographic record
Abstract
More North American Aboriginal women are being diagnosed with gestational diabetes mellitus (GDM) than the general population. Despite the association of a number of health problems with GDM, there have been few evaluations of GDM prevention projects. Nor have investigators looked at Aboriginal women’s understandings of GDM in an effort to develop appropriate and effective health strategies. A qualitative investigation was therefore proposed to describe the experiences of Aboriginal women with GDM. The study began with unstructured interviews and focus groups with 25 advisors such as maternal care providers and community representatives working with Aboriginal women. Semi-structured explanatory model interviews were then conducted with 29 Aboriginal women in Winnipeg, the capital city of Manitoba, Canada. Fixed-response interviews were also administered and analyzed using cultural consensus analysis to determine whether or not shared cultural understandings existed among the Aboriginal women participants. Results of the consensus analysis revealed biomedical understandings were the most commonly shared. A more variable response was associated with women’s personal interpretations of GDM, leading to weak consensus overall. Thematic analysis of the semi-structured interviews illustrated the fear, anxiety and frustration many participants experienced with GDM. Women discussed their emotional reactions alongside negative relationships with food and other prescribed lifestyle treatments. These perspectives, combined with results from the group of advisors, pointed to communication and cultural barriers which may limit the quality of prenatal care received. Collectively the results suggest living with GDM can be overwhelming and underscore the need for health care providers to encourage self-efficacy and emotional security towards effective management practices. Research contributing to a more comprehensive understanding of Aboriginal women’s experiences with GDM is also required, to provide further perspective for diabetes prevention and positive change.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.022 | 0.008 |
| Scholarly communication | 0.005 | 0.001 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".