Suet yee Chow
Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications and is associated with increased risks of adverse maternal and neonatal outcomes. Effective management requires ongoing health education, self-management, behavioural modification, and psychosocial support. However, antenatal care in many public healthcare settings remains largely individualised and medically focused, which may limit opportunities for peer support, shared learning, and relationship-centred care. Group antenatal care (GANC) is an innovative model of maternity care that integrates clinical assessment, health education, and peer support within a group setting. International studies have demonstrated promising benefits of GANC, including improved pregnancy experiences, increased health knowledge, enhanced self-efficacy, and improved maternal and neonatal outcomes. Despite growing international evidence, GANC has not been implemented within the Hong Kong public healthcare system, and little is known about its feasibility, acceptability, and effectiveness in a medically dominated hospital environment. This doctoral study aims to introduce and evaluate a GANC programme for pregnant women with GDM within a Hong Kong public hospital setting. Guided by implementation science principles, the study will assess both clinical and implementation outcomes. Specifically, the study will evaluate the effectiveness of GANC in improving maternal experiences, diabetes self-management, and selected pregnancy outcomes, while simultaneously exploring the facilitators and barriers influencing implementation from the perspectives of women, midwives, and other key stakeholders. Using a mixed-methods approach, quantitative data will be collected to evaluate maternal, clinical, and service outcomes, while qualitative data will explore participant experiences and contextual factors affecting implementation. Findings will inform the adaptation and integration of GANC within the local maternity care context and contribute to the development of a sustainable model of woman-centred care for women with GDM. This study is expected to generate evidence to support the implementation of GANC in Hong Kong and provide insights into how relational, midwife-led models of care can be incorporated into public healthcare systems. Ultimately, the project seeks to enhance women's pregnancy experiences, strengthen self-management of GDM, and support professional midwifery practice through the promotion of collaborative, relationship-based care.