Gestational Diabetes Mellitus and Physical Activity: Exploring the Issues among Asian Population in the UK and Advocating for Policy Change: A Mixed-Method Study

Abstract

Background and aim: Gestational Diabetes Mellitus (GDM), a glucose intolerance disorder resulting in hyperglycaemia, affects approximately one in every 23 pregnancies in the United Kingdom (UK). Compared to other ethnic groups in the UK, Asian-born women have a higher rate of GDM (5.8%). Physical activity is reported to have numerous benefits for both the expectant mother and foetus, such as improving insulin sensitivity and reducing the risk of developing GDM. This study examines the patterns of physical activity that impact GDM occurrence among Asian pregnant women living in the UK by: 1) assessing the association between patterns of physical activity engagement by Asian pregnant women and GDM occurrence; 2) gaining insight into Asian women’s knowledge of GDM and identifying barriers to and enablers of physical activity during pregnancy. Method: This research employed an explanatory sequential mixed method design comprising two phases. Data for the first phase were collected from 75 participants using a Pregnancy Physical Activity Questionnaire (PPAQ). In the second phase, semi-structured interviews were conducted with 13 participants. Findings: Chi-squared test and logistic regression analysis revealed no significant association between physical activity based on different variables during pregnancy and GDM occurrence in the first phase. However, sports/exercise, occupational, and light-intensity physical activities indicated a protective effect against GDM. Thematic analysis in the second phase identified four themes aligned with the socioecological model framework underpinning the study context. Both quantitative and qualitative findings were integrated into a joint display table to enable an in-depth evaluation of the interactions among intrapersonal, interpersonal, and environmental factors influencing changes in physical activity behaviour among pregnant Asian women. Conclusions and recommendations: This thesis has made a unique contribution to existing knowledge on physical activity during pregnancy and the occurrence of GDM among Asian women in the UK. Application of the socioecological model provided evidence of changes in physical activity behaviour and the influence of individual, social, and environmental factors. These findings are significant for various domains, including public health, and groups such as policy health advisors, and healthcare professionals concerned with female prenatal health. Future studies should support practice in culturally appropriate strategies for promoting physical activity by ensuring that solutions are culturally relevant rather than a one-size-fits-all approach. Understanding Asian culture will allow healthcare providers to effectively address the specific requirements of this demographic of pregnant women rather than simply adopting current guidelines, which may be inadequate.