Understanding gestational diabetes in Hong Kong: women’s needs, self-management challenges, and the potential of digital health solutions in culturally sensitive care

Abstract

Background: Gestational diabetes mellitus (GDM), defined as glucose intolerance first recognised during pregnancy, poses serious health risks to mothers and newborns. The alarmingly high GDM prevalence in Hong Kong (25.9%), which is double the global average, necessitates urgent examination of context-specific management challenges. This qualitative study explored the experiences of Hong Kong Chinese women with GDM, investigating their perceived needs, self-management barriers, and recommendations for culturally appropriate healthcare interventions. Methods: Semi-structured interviews were conducted with 16 women diagnosed with GDM across Hong Kong. Participants included both pregnant women and those within 12 months postpartum, all of whom were managing their condition in a community setting. The interview guide was developed using the Health Belief Model (HBM) as a framework. Thematic analysis was then used inductively to identify key patterns in participants’ self-management experiences and healthcare needs related to GDM. Results: Analysis confirmed the relevance of all core HBM constructs (perceived susceptibility/severity, barriers, benefits, cues to action, and self-efficacy), revealing their unique manifestations in this context. Key barriers included cultural conflicts in diet, time and fatigue limiting exercise, and insufficient healthcare support. Motivators included protection of the baby’s health and cues from healthcare providers and peers. Women expressed a strong preference for culturally tailored digital health tools to bridge these gaps. Conclusion: There is an urgent need for integrated, family-centered digital health solutions that offer culturally adapted dietary advice, trimester-specific guidance, and embedded psychological support. Hong Kong’s sociocultural context provides an ideal setting for developing such interventions, with lessons applicable to other populations navigating tensions between tradition and modern healthcare.