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Assessing Reproductive Health Knowledge in Female Adolescents with Diabetes

Denise Charron-Prochownik, PhD, CPNP, FAAN, Andrea F.R. Fischl, PhD, MHP, Susan M. Sereika, PhD, Kaitlin Malone, BSN, Patricia Schmitt, MPM, Julie Downs, PhD


Objective: Women with diabetes have increased risks of pregnancy-related complications. Knowledge of preventing these risks can be helpful. This paper describes the understanding and knowledge of diabetes and reproductive health of adolescent females with type 1 diabetes (T1D).

Research Design and Methods: For this secondary analysis, a descriptive mixed-method design was employed using baseline data from adolescents enrolled in a preconception counseling (PC) intervention study (READY-Girls program) targeting adolescent women with diabetes to enhance reproductive health awareness, knowledge, beliefs, decision-making skills and behaviors. Participants (aged 13-20yrs) were recruited from 2 university-based diabetes clinics. Content analysis was used to identify recurring themes on 3-open-ended computer-based questions regarding the understanding of diabetes and pregnancy, contraception, and PC; kappa coefficients were used to assess inter-coder agreement. Subscale scores from multiple-choice vignettes were computed in terms of 100% correctness (<70%indicated low levels) for knowledge of diabetes and pregnancy, contraception, and PC. Qualitative and quantitative results were compared.

Results: Participants (n=101) were on average 15.8yrs, 21% were sexually active with a mean age at sexual debut of 15.3yrs. Overarching themes from qualitative data were that participants knew little or nothing and had misconceptions regarding diabetes and pregnancy, contraception, and PC. Inter-coder agreement for content analysis was high. Knowledge scores were low (diabetes and pregnancy, 64.5%; diabetes and contraception, 79.8%; PC, 67.5%).

Conclusion: Risky behavior and low knowledge scores confirmed their perceived lack of understanding from the open-ended questions regarding diabetes and pregnancy and PC. Teens had greater knowledge of contraception. Diabetes education should include PC and reproductive health for teens with diabetes.

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