Gestational diabetes significantly increases the risk of developing type 2 diabetes after pregnancy, but physical activity can help reduce this risk. Most interventions for women post-gestational diabetes have not effectively improved physical activity levels, even when dietary changes or weight loss were achieved. This study developed theory-based recommendations to enhance physical activity after gestational diabetes using a realist-inspired approach and the socio-ecological model.

An advisory group guided the study, which included input from women with gestational diabetes, researchers, and public health professionals. Ten theories were generated, emphasizing the need for women to feel empowered, supported beyond family, and have access to affordable childcare in physical activity settings. Recommendations were made across social, organizational, community, and policy levels.

Key findings indicate that improving continuity of care and follow-up appointments is crucial for engaging women in physical activity discussions. Utilizing community resources and providing co-located childcare are essential for enabling women to participate in physical activities tailored to their needs.