Background/Aim: To examine factors influencing the uptake and use of diabetic services amongcommunity-dwelling Black African-Caribbean people living in the UK.
Methods: Nineteen individuals of African-Caribbean heritage, over the age of 50 years, diagnosed with type 2 diabetes, took part in three ninety-minute focus group interviews (FGIs). These interviews were facilitated by a community-based health champion and a researcher of African-Caribbean ethnicity. Audio recordings were transcribed verbatim, coded in NVivo software, and analyzed using an inductive thematic approach.
Results: Culturally specific and nonspecific (generic) themes were identified. Culturally specific themes included the normalization of diabetes within the community and a discordant perception about what constitutes healthy eating such as the belief that food not grown organically, or that unfamiliar food is not healthy. Participants were found to be inclined to either substitute or complement diabetes medications with cultural herbal remedies. Participants were generally found to be sceptical about the effectiveness of prescribed medications. There was a lack of confidence and/or trust in medical-centric advice received from healthcare practitioners, often exacerbated by their conflicting messages. Participants also expressed that healthcare practitioners do not always listen to or understand Black people’s culture and needs and reported that there was a lack of culturally appropriate diabetes education and training programs for their community. Generic themes included difficulties and frustrations in getting doctor’s appointments, short appointment times, self-indiscipline, and poor motivation for engaging in physical exercise and healthy eating.
Conclusion: Several cultural/community-related factors influence good control of diabetes, including knowledge and understanding of diabetes and the uptake of healthcare services in African-Caribbean people living in the UK, alongside more general individual and system-related barriers. Addressing these issues is imperative in designing a culturally sensitive diabetes education program for these people. The program's effectiveness could be enhanced by delivering it in accessible formats at the community level and utilizing racially concordant health champions or community ambassadors.