Exploring structural barriers to diabetes self-management in Alberta First Nations communities
Abstract Background Type 2 diabetes is highly prevalent in Canadian First Nations (FN) communities. FN individuals with diabetes are less likely to receive guideline recommended care and access specialist care. They are also less likely to be able to engage in optimal self-management behaviours. Whi...
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | http://link.springer.com/article/10.1186/s13098-018-0385-7 |
| _version_ | 1811203652903239680 |
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| author | Stephanie Kulhawy-Wibe Kathryn M. King-Shier Cheryl Barnabe Braden J. Manns Brenda R. Hemmelgarn David J. T. Campbell |
| author_facet | Stephanie Kulhawy-Wibe Kathryn M. King-Shier Cheryl Barnabe Braden J. Manns Brenda R. Hemmelgarn David J. T. Campbell |
| author_sort | Stephanie Kulhawy-Wibe |
| collection | DOAJ |
| description | Abstract Background Type 2 diabetes is highly prevalent in Canadian First Nations (FN) communities. FN individuals with diabetes are less likely to receive guideline recommended care and access specialist care. They are also less likely to be able to engage in optimal self-management behaviours. While the systemic and racial contributors to this problem have been well described, individuals’ experiences with structural barriers to care and self-management remain under-characterized. Methods We utilized qualitative methods to gain insight into the structural barriers to self-management experienced by FN individuals with diabetes. We conducted a qualitative descriptive analysis of a subcohort of patients with diabetes from FN communities (n = 5) from a larger qualitative study. Using detailed semi-structured telephone interviews, we inquired about participants’ diabetes and barriers to diabetes self-management. Inductive thematic analysis was performed in duplicate using NVivo 10. Results The structural barriers faced by this population were substantial yet distinct from those described by non-FN individuals with diabetes. For example, medication costs, which are usually cited as a barrier to care, are covered for FN persons with status. The barriers to diabetes self-management that were commonly experienced in this cohort included transportation-related difficulties, financial barriers to uninsured health services, and lack of accessible diabetes education and resultant knowledge gaps. Conclusions FN Albertans with diabetes face a myriad of barriers to self-management, which are distinct from the Non-FN population. In addition to the barriers introduced by colonialism and historical injustices, finances, geographic isolation, and lack of diabetes education each impede optimal management of diabetes. Programs targeted at addressing FN-specific barriers may improve aspects of diabetes self-management in this population. |
| first_indexed | 2024-04-12T02:58:53Z |
| format | Article |
| id | doaj.art-c5d5d02cb1f749b49ee4eec11f7c421b |
| institution | Directory Open Access Journal |
| issn | 1758-5996 |
| language | English |
| last_indexed | 2024-04-12T02:58:53Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj.art-c5d5d02cb1f749b49ee4eec11f7c421b2022-12-22T03:50:44ZengBMCDiabetology & Metabolic Syndrome1758-59962018-12-011011710.1186/s13098-018-0385-7Exploring structural barriers to diabetes self-management in Alberta First Nations communitiesStephanie Kulhawy-Wibe0Kathryn M. King-Shier1Cheryl Barnabe2Braden J. Manns3Brenda R. Hemmelgarn4David J. T. Campbell5Department of Medicine, Cumming School of Medicine, University of CalgaryDepartment of Community Health Sciences, Cumming School of Medicine, O’Brien Institute for Public Health, Libin Cardiovascular Institute of Alberta, Faculty of Nursing, University of CalgaryDepartments of Medicine and Community Health Sciences, Cumming School of Medicine, O’Brien Institute for Public Health, Libin Cardiovascular Institute of Alberta, University of CalgaryDepartments of Medicine and Community Health Sciences, Cumming School of Medicine, O’Brien Institute for Public Health, Libin Cardiovascular Institute of Alberta, University of CalgaryDepartments of Medicine and Community Health Sciences, Cumming School of Medicine, O’Brien Institute for Public Health, Libin Cardiovascular Institute of Alberta, University of CalgaryDepartment of Medicine, Cumming School of Medicine, University of CalgaryAbstract Background Type 2 diabetes is highly prevalent in Canadian First Nations (FN) communities. FN individuals with diabetes are less likely to receive guideline recommended care and access specialist care. They are also less likely to be able to engage in optimal self-management behaviours. While the systemic and racial contributors to this problem have been well described, individuals’ experiences with structural barriers to care and self-management remain under-characterized. Methods We utilized qualitative methods to gain insight into the structural barriers to self-management experienced by FN individuals with diabetes. We conducted a qualitative descriptive analysis of a subcohort of patients with diabetes from FN communities (n = 5) from a larger qualitative study. Using detailed semi-structured telephone interviews, we inquired about participants’ diabetes and barriers to diabetes self-management. Inductive thematic analysis was performed in duplicate using NVivo 10. Results The structural barriers faced by this population were substantial yet distinct from those described by non-FN individuals with diabetes. For example, medication costs, which are usually cited as a barrier to care, are covered for FN persons with status. The barriers to diabetes self-management that were commonly experienced in this cohort included transportation-related difficulties, financial barriers to uninsured health services, and lack of accessible diabetes education and resultant knowledge gaps. Conclusions FN Albertans with diabetes face a myriad of barriers to self-management, which are distinct from the Non-FN population. In addition to the barriers introduced by colonialism and historical injustices, finances, geographic isolation, and lack of diabetes education each impede optimal management of diabetes. Programs targeted at addressing FN-specific barriers may improve aspects of diabetes self-management in this population.http://link.springer.com/article/10.1186/s13098-018-0385-7Diabetes mellitusFirst NationsBarriers to careAccess to careDiabetes educationFinancial barriers |
| spellingShingle | Stephanie Kulhawy-Wibe Kathryn M. King-Shier Cheryl Barnabe Braden J. Manns Brenda R. Hemmelgarn David J. T. Campbell Exploring structural barriers to diabetes self-management in Alberta First Nations communities Diabetology & Metabolic Syndrome Diabetes mellitus First Nations Barriers to care Access to care Diabetes education Financial barriers |
| title | Exploring structural barriers to diabetes self-management in Alberta First Nations communities |
| title_full | Exploring structural barriers to diabetes self-management in Alberta First Nations communities |
| title_fullStr | Exploring structural barriers to diabetes self-management in Alberta First Nations communities |
| title_full_unstemmed | Exploring structural barriers to diabetes self-management in Alberta First Nations communities |
| title_short | Exploring structural barriers to diabetes self-management in Alberta First Nations communities |
| title_sort | exploring structural barriers to diabetes self management in alberta first nations communities |
| topic | Diabetes mellitus First Nations Barriers to care Access to care Diabetes education Financial barriers |
| url | http://link.springer.com/article/10.1186/s13098-018-0385-7 |
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