465-P: Applying the Ancestral Knowledge System Framework to Interviews with Key Stakeholders Regarding a Gestational Diabetes Mellitus Risk Reduction and Reproductive Health Planning Program for American Indian Adolescent Females

Gestational Diabetes Mellitus (GDM) is the most common complication of pregnancy and potentially causes problemsfor both mother and baby, including risks of developing type 2 diabetes (T2D). Compared to other Americans, Indigenous youth have more risk factors and higher rates of GDM. We developed Stopping GDM a GDM risk reduction and reproductive health program for American Indian adolescent females. To further deepen the cultural strengths of the program we draw on constructs from Indigenous ways of knowing, such as Ancestral Knowledge System (AKS). We conducted a secondary analysis on an existing qualitative dataset collected during the Stopping GDM study using AKS as a secondary framework. Key constructs from AKS include: relationships, place-based knowledge, generational networks, holistic approaches, language, cultural heritage, and critical reflection. This dataset includes focus groups with AI adolescent girls (age 12-20) (n=13); their adult female caregivers (n=9); and AI women with a history of GDM or T2D (n=5) from two urban sites. All focus groups were moderated by a trained qualitative researcher with a notetaker and semi-structured moderator guide and analyzed using Atlas.ti. Four primary themes supported by the AKS framework constructs emerged: 1) the important and unique role of women in Native communities; 2) traditional ways as they relate to women, reproductive health, and wellness; 3) support for women’s wellness and reproduction; 4) social determinants as challenges for Indigenous communities in promoting healthy behaviors. These findings will be used to support expansion of Stopping GDM to increase its cultural relevance for a broader Indigenous priority audience which includes Native Hawaiian and Alaska Native communities.