Contraceptive decision making by Latina diabetics
Awarded 2007
Large Research Grants
Stephanie Teal, MD, MPH
University of Colorado

Mistimed pregnancy in diabetics may lead to significant health risks. Although good glycemic control prior to pregnancy can ameliorate these risks, most diabetic pregnancies start with suboptimal glucose control. Pregnancy planning requires effective contraceptive use. Little is known about contraceptive decision-making by diabetic women, and barriers to contraceptive use they face. Women from minority populations confronting health disparities may be at higher risk. Latina women have both a high prevalence of diabetes and a very high fertility rate. This proposal is the first step in a research agenda with the goal of identifying clinical, psychosocial, and health services factors that affect contraceptive use by Latina diabetics, consistent with the SFP mission of advancing the science and delivery of family planning. In Aim 1, we will design and test a life history calendar which links reproductive and diabetic events. In Aim 2, we will administer the calendar to 50 low-income, urban Latinas, 30 diabetic and 20 non-diabetic, then compare variables of contraceptive use and reproductive outcomes. In Aim 3, we will use qualitative interviews which draw on these life histories to explore themes influencing reproductive behavior. Contributions of this project include 1) a pilot-tested life event calendar which combines reproductive history with the personal history of diabetes. This will be useful for future work on family planning in Latina diabetics, and for studying family planning by others with chronic diseases; 2) data on contraceptive use and reproductive patterns of this population, and influences of diabetes on these decisions; and 3) the qualitative data to develop measures for refined constructs relevant to contraceptive decision-making by Latina diabetics, with a testable conceptual framework for this population. We may then identify critical components of future interventions to improve reproductive health in this growing population which faces high risks of poor perinatal outcome.