Healthy Behaviors and Choices (e.g. Fitness, Tobacco, Opioids, Nutrition)
Sharing Session - 30 Minutes
Jacqueline LaManna, PhD, APRN, ANP-BC, BC-ADM, CDE
Assistant Professor
University of Central Florida college of Nursing
.jpg "Maria Stahl, DNP, RN photo")
Maria Stahl, DNP, RN
Administrator/Health Officer
Florida Department of Health in Brevard County
Patricia Seibert, RN, BSN
Executive Community Health Nursing Director
Florida Department of Health in Brevard County
Diabetes is one of the most common conditions complicating pregnancy, particularly in women with baseline perinatal risk including advanced maternal age and obesity. Prevalence of diabetes in pregnancy, both pre-existing and gestational, is increasing. Between 2009—2015, Florida Medicaid claims for gestational diabetes mellitus (GDM) diagnoses rose by 50%, while claims for pregestational diabetes doubled. Diabetes has potential to adversely affect perinatal outcomes. Optimal maternal and fetal outcomes are achieved when glucose levels are well-controlled prior to and during pregnancy utilizing a team approach that addresses lifestyle change and maternal and fetal well-being. Access to comprehensive diabetes support programs is often limited for women impacted by health and social disparities.
Consistent with national and state trends, the prenatal clinic at the Florida Department of Health in Brevard County observed an increase in pregnancies complicated by diabetes in a diverse population of medically underserved women. In response to staff challenges completing specialty referrals, a comprehensive on-site endocrine specialty clinic was established, expanding upon an established public/private partnership model. This presentation will describe the design, implementation, and client outcomes achieved by this prototype clinic and will elaborate on the benefits of integrating early diabetes case finding, referral, clinical management, self-management education and support, and follow-up for a medically and socially priority group of childbearing women. Successes, challenges, and future opportunities including academic partnerships will be discussed. This initiative supports national and state-level priorities aimed at incorporating programs that support elements health equity aimed at improving the health outcomes of childbearing women and their children.