TY - JOUR
AU - K. Sushko
AU - M. Racey
AU - D. Sherifali
AU - K. Smith
AU - K. Fleming
AU - S. Banwatt
AU - L. Lipscombe
A1 - 
AB - BACKGROUND: Women with gestational diabetes mellitus (GDM) are at high risk for the development of type 2 diabetes (T2D). Although postpartum diabetes prevention programs (DPPs) reduce the risk of diabetes after pregnancy, the transition from prenatal to postpartum diabetes care is suboptimal. As primary care providers (PCPs) are generally responsible for providing postpartum preventive care, incorporating PCPs' perspectives in the co-design of a DPP is essential to optimize the integration of prenatal and postpartum diabetes care and DPP implementation. METHODS: We used a qualitative descriptive study design to elicit PCP perspectives on implementing a new multi-centre DPP for patients with recent GDM. We purposefully sampled primary care physicians (PCPs) from Primary Care Networks connected with each DPP centre and conducted a focus group and individual one-on-one interviews. Directed conventional content analysis, based on Valentijn's integrative functions of primary care, guided the analysis of focus group and interview transcripts. RESULTS: Our analysis identified three overarching themes that align with Valentijn's micro, meso, and macro dimensions of integrated care. Micro-level integration focused on improving prenatal to postpartum care transition between providers and leveraging opportunities to integrate maternal and newborn care. Meso-level integration emphasized the need for a team-based model of care that incorporates allied health professionals and optimizes communication between these groups. Integration at the macro level included developing processes to delineate responsibility for postpartum T2D testing while reducing the burden on women through more efficient testing methods. CONCLUSIONS: The PCP perspective provides a valuable addition to the implementation strategy of a new multi-centre DPP for patients with recent GDM. To optimize the integration of prenatal and postpartum diabetes care and uptake of a DPP, PCP recommendations included leveraging newborn care, building on team-based care models, and more efficient postpartum T2D testing processes. Incorporating these themes will enable a smoother transition of care and improve the effective implementation of a postpartum DPP. TRIAL REGISTRATION: Not applicable.
AD - Women's College Research and Innovation Institute, Women's College Hospital, Toronto, ON, M5G 1N8, Canada. katelyn.sushko@wchospital.ca.; Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, L8S 4K1, Canada.; Michael Garron Hospital, Toronto, M4C 3E7, Canada.; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, M5S 1A1, Canada.; Department of Family and Community Medicine, University of Toronto, Toronto, M5G 1V7, Canada.; Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, M4N 3M5, Canada.; CarePoint Health, Mississauga, ON, L5K 2PE, Canada.; Women's College Research and Innovation Institute, Women's College Hospital, Toronto, ON, M5G 1N8, Canada.
AN - 42243714
BT - BMC Prim Care
C5 - Healthcare Disparities; Education & Workforce
CP - 1
DA - 06/2026
DO - 10.1186/s12875-026-03412-4
DP - NLM
ET - 20260605
IS - 1
JF - BMC Prim Care
LA - eng
N2 - BACKGROUND: Women with gestational diabetes mellitus (GDM) are at high risk for the development of type 2 diabetes (T2D). Although postpartum diabetes prevention programs (DPPs) reduce the risk of diabetes after pregnancy, the transition from prenatal to postpartum diabetes care is suboptimal. As primary care providers (PCPs) are generally responsible for providing postpartum preventive care, incorporating PCPs' perspectives in the co-design of a DPP is essential to optimize the integration of prenatal and postpartum diabetes care and DPP implementation. METHODS: We used a qualitative descriptive study design to elicit PCP perspectives on implementing a new multi-centre DPP for patients with recent GDM. We purposefully sampled primary care physicians (PCPs) from Primary Care Networks connected with each DPP centre and conducted a focus group and individual one-on-one interviews. Directed conventional content analysis, based on Valentijn's integrative functions of primary care, guided the analysis of focus group and interview transcripts. RESULTS: Our analysis identified three overarching themes that align with Valentijn's micro, meso, and macro dimensions of integrated care. Micro-level integration focused on improving prenatal to postpartum care transition between providers and leveraging opportunities to integrate maternal and newborn care. Meso-level integration emphasized the need for a team-based model of care that incorporates allied health professionals and optimizes communication between these groups. Integration at the macro level included developing processes to delineate responsibility for postpartum T2D testing while reducing the burden on women through more efficient testing methods. CONCLUSIONS: The PCP perspective provides a valuable addition to the implementation strategy of a new multi-centre DPP for patients with recent GDM. To optimize the integration of prenatal and postpartum diabetes care and uptake of a DPP, PCP recommendations included leveraging newborn care, building on team-based care models, and more efficient postpartum T2D testing processes. Incorporating these themes will enable a smoother transition of care and improve the effective implementation of a postpartum DPP. TRIAL REGISTRATION: Not applicable.
PY - 2026
SN - 2731-4553
ST - Integrating the primary care perspective in the implementation of a diabetes prevention program for patients with recent gestational diabetes: a qualitative descriptive study
T1 - Integrating the primary care perspective in the implementation of a diabetes prevention program for patients with recent gestational diabetes: a qualitative descriptive study
T2 - BMC Prim Care
TI - Integrating the primary care perspective in the implementation of a diabetes prevention program for patients with recent gestational diabetes: a qualitative descriptive study
U1 - Healthcare Disparities; Education & Workforce
U3 - 10.1186/s12875-026-03412-4
VL - 27
VO - 2731-4553
Y1 - 2026
ER -