The study begins with cultural adaptation and translation of the Postnatal Well‑being in Transition questionnaire for use with Thai women with type 2 diabetes. Written authorization to translate and validate the instrument was granted by the original developer. The research team follows the six‑stage translation process described by Beaton and colleagues (2000). Two bilingual Thai–English nursing faculty performed independent forward translations; a synthesized Thai version was produced and then independently back‑translated by two additional bilingual faculty. The team resolved discrepancies in a consensus meeting to produce the final Thai version prior to psychometric testing.
Content validation was undertaken with three Thai postnatal care experts. The study reports calculation of the Item‑level Content Validity Index (I‑CVI) during the validation process. Details on further psychometric testing (e.g., reliability statistics) are not reported in this protocol beyond the translation and content validity steps described.
This protocol employs an explanatory sequential mixed‑methods design to investigate relationships between social determinants of health and postnatal well‑being during the postpartum diabetes transition. The design comprises two distinct phases: a quantitative strand to describe patterns and associations, followed by a qualitative strand intended to elaborate and explain the quantitative findings.
The quantitative component will generate generalizable data on SDoH and postnatal well‑being among Thai women with T2DM. The subsequent qualitative interviews will probe lived experiences, offering contextualized explanations for patterns observed in the numerical data. The investigators plan to integrate results from both strands using triangulation to identify convergences, divergences, and complementary explanations.
Data collection will take place at two public hospitals in Thailand selected to capture contrasting contexts: an urban tertiary care center in Bangkok serving a high‑density, socioeconomically diverse population, and a suburban hospital in Samut Prakan serving a more stable, primarily middle‑income residential community. This dual‑site approach uses maximum variation sampling to reflect distinct geographic and socioeconomic influences on maternal health.
Participants for the quantitative phase are postnatal women with T2DM who delivered within the past six weeks. A purposive subsample of participants will be selected for the qualitative phase to explore themes arising from quantitative results.
The quantitative phase will recruit 50 postnatal women with type 2 diabetes. Each participant will provide data on demographic characteristics, measures of social determinants of health across relevant domains, and scores on the translated Postnatal Well‑being in Transition instrument. The protocol specifies use of the translated and validated questionnaire but does not report additional specific instruments for SDoH beyond the study’s planned measures described above.
Quantitative analysis will describe SDoH and postnatal well‑being scores and identify patterns to guide selection of interview participants for the qualitative strand. The protocol emphasizes that the quantitative results will inform purposive sampling for the interviews, selecting women based on mean postnatal well‑being scores to capture a range of experiences.
From the 50‑participant quantitative cohort, 12 women will be invited to participate in semi‑structured, one‑on‑one interviews. These interviews aim to explore individual experiences of SDoH during the postpartum transition with T2DM and to explain how contextual factors relate to participants’ postnatal well‑being scores.
Interview data will be used to elaborate on and interpret quantitative findings. The protocol indicates use of standard qualitative methods for in‑depth exploration but does not provide full detail of the qualitative analytic framework (e.g., specific coding approach) within the text presented in this protocol excerpt.
The study plans explicit integration of quantitative and qualitative data. Triangulation will be applied to validate and enrich findings, allowing the research team to identify convergent, divergent, and complementary explanations for observed relationships between SDoH and postnatal well‑being among women with T2DM. This integrated approach is intended to support development of culturally appropriate, evidence‑based recommendations for postnatal care tailored to women with diabetes.
Ethical approval for the study has been obtained from the Human Research Ethics Committee, Faculty of Medicine Ramathibodi Hospital, Mahidol University. The protocol states that data have not yet been collected and therefore data cannot be shared at present. The authors report they received no specific funding for this work and declare no competing interests. Study findings are intended to be reported in international journals.
Overall, this protocol outlines a systematic process for translating an outcome instrument, collecting quantitative measures of SDoH and postnatal well‑being in a defined postpartum T2DM sample, and using targeted qualitative interviews to contextualize and explain quantitative results. The dual‑site Thai setting and the sequential mixed‑methods design aim to produce actionable insights to inform culturally appropriate postnatal care for women with type 2 diabetes.