A grounded theory of type 2 diabetes prevention and risk perception.

Ishfaq Vaja,Kanayo F Umeh,Julie C Abayomi,Tasneem Patel,Lisa Newson

doi:10.1111/bjhp.12503

Abstract

Type 2 diabetes (T2D) prevention programmes should target high-risk groups. Previous research has highlighted minimal engagement in such services from South Asian (SA) people. Given SA's elevated risk of T2D, there is a need to understand their perceptions, risks, and beliefs about T2D. This study aimed to assess T2D risk perception within a community sample of SA people using Grounded Theory methodology. Specifically, health beliefs were assessed, and we explored how these beliefs affected their T2D risk perceptions. Twenty SA participants (mean age=38years) without a diagnosis of T2D were recruited from community and religious settings across the North West of England. In line with grounded theory (Strauss & Corbin, 1990, Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park: Sage Publications), data collection and analysis coincided. The superordinate category of Culturally Situated Risk Perception incorporated a complex psychological understanding of the formation of T2D risk perception, which takes into account the social, cultural, and community-based environmental factors. This superordinate category was explained via two core categories (1) Diminished Responsibility, informed by sub-categories of Destiny and Heredity, and (2) Influencing Healthy Lifestyle Behaviours, informed by sub-categories of Socio-cultural and Environmental. This study investigated risk perception of T2D within the SA community. When considering health prevention in the context of an individual's culture, we need to consider the social context in which they live. Failure to acknowledge the cultural-situated T2D risk perception relevant to health promotion and illness messages may account for the issues identified with health care engagement in the SA population.

Highlights

In the United Kingdom (UK), 3.9 million people have a diagnosis of diabetes
The process of memo writing during study conceptualization, before and after interviews, and during the analytical processes further enhanced the analytical commentary through researcher reflections, which considered the acknowledgement of theoretical stances and literature, the focus remained on the research data itself (Lempert, 2007). We propose that this original study considers a broad context relevant to the psychological understanding of type 2 diabetes (T2D) risk perception, which can be applied directly to behaviour change interventions relevant to the individual and community and population-based approaches to health communication
South Asian (SA) participants we influenced by external factors which lead them towards a sense of diminished responsibility in understanding and engaging with T2D prevention and risk acceptance

Summary

Introduction

In the United Kingdom (UK), 3.9 million people have a diagnosis of diabetes. Public Health England (PHE, 2018a) estimate there are 5 million people, in England alone, who are at high risk of developing T2D. A specific health inequality exists for people of South Asian (SA) descent, who are vulnerable to T2D (Gujral, Pradeepa, Weber, Narayan, & Mohan, 2013; PHE, 2018b). Despite the higher susceptibility for SA people, the NHS National Diabetes Audit (2020) suggests that SA people are not frequently identified through primary care (in the United Kingdom this is the first-line access to health provision). It is predicted that the prevalence of T2D in the United Kingdom will simultaneously increase (Gujral et al, 2013; Rowley, Bezold, Arikan, Bryne, & Krohe, 2017)

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Discussion

Conclusion