An equity audit on program completion among women with a history of gestational diabetes in a state-funded diabetes and cardiovascular risk reduction program

Purpose

To assess the completion of the type 2 diabetes, heart disease and stroke prevention program (the Life!) among women with a history of gestational diabetes mellitus (GDM) according to participants’ characteristics.

Methods

Data from women with a history of GDM enrolled in the Life! program in Victoria, Australia, between 2014 and 2022 were analysed. Completion rates were assessed using the PROGRESS-Plus (Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status, and Social capital Plus age and smoking) framework. Multivariable logistic regression model was fitted.

Results

A total of 2399 women with a history of GDM were enrolled in the program, of which 55 % completed it. Characteristics associated with higher completion rates included being from metropolitan areas (AOR = 1.52, 95 % CI: 1.14–2.01) compared with being from regional areas, having a body mass index in a normal range (AOR = 1.50, 95 % CI: 1.06–2.15) compared with having overweight or obesity, having middle income (AOR = 1.41, 95 % CI: 1.01–1.98) compared with having low- or high-income, and enrolment after 2019 (AOR = 2.3, 95 % CI:1.80–3.06) compared with enrolment in 2019 or earlier. Conversely, having a South or Central Asian background (AOR = 0.65, 95 % CI: 0.46–0.92) is associated with a lower completion rate compared with being from Australia.

Conclusion

Characteristics associated with lower completion rates among women with prior GDM in a cardiometabolic risk reduction program included residing in rural and remote areas, having an elevated BMI (in the overweight or obesity range), low or high income, enrolment in 2019 or earlier and being of South or Central Asian background.