Trust in Physician and Health Agency Impact Postpartum Choices in Women with Gestational Diabetes
ACOG ePoster. Spelke B. Apr 27, 2018; 211965; 20N
Bridget Spelke
Bridget Spelke
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Introduction: Trust in physicians and health agency have been associated with adherence in primary care, but have not been evaluated in the postpartum setting. We assessed the role of these constructs in adherence to postpartum best-practices among women with gestational diabetes mellitus (GDM).

Methods: A prospective cohort of 300 women with GDM completed the validated Trust in Physician Scale (Cronbach alpha 0.81) during their postpartum hospitalization. Participants rated health agency with a 4-point Likert scale evaluating the statement, “I feel that I have little control over risks to my health”. Chart review determined postpartum visit attendance, glucose testing, and sustained breastfeeding. Contraceptive use was collected via telephone interview at 3 months postpartum. Trust and agency were compared with Kruskal-Wallis and Wilcoxon rank sum tests respectively. Confounders were accounted for in multivariable models.

Results: By 12 weeks postpartum, 83% of participants had attended postpartum visits, 61% of whom were breastfeeding, and 42% had completed postpartum glucose testing. Of 226 participants who completed telephone interviews, 66% reported using contraception. Trust did not differ by demographics or pregnancy outcome. Health agency differed by income and race/ethnicity. Trust and health agency were not associated with postpartum visit adherence, but greater trust was associated with postpartum glucose testing adherence (P
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