Necessity, Concepts and Feasibility of Culturally Tailored Diabetes Education for Migrants in the Netherlands and the United Kingdom: A Qualitative Study on Experts' Views

Abstract

Purpose: The aim of this study was to investigate experts´ perspectives concerning necessity, concepts and feasibility of culturally tailored diabetes education for ethnic minority groups in the Netherlands and the United Kingdom. Background: Prevalence rates of Type 2 Diabetes Mellitus (T2DM) are high, especially among under-served population groups including ethnic minority groups (EMGs). There has been increasing recognition that T2DM education programmes are critical to good diabetes selfmanagement. Although studies have shown that disadvantaged population groups are less able to benefit from standard interventions, only a few culturally tailored diabetes interventions exist in the European region. Methods: A comparative qualitative case study was carried out, that combines expert interviews and document analysis. Six semi-structured guideline-based interviews were conducted in the Netherlands and the United Kingdom. The generated data was analysed in the framework of qualitative content analysis. Results: Four interventions in two countries were included. Findings showed that country-specific systems and decisions on a structural level have a strong impact on availability and implementation of culturally tailored diabetes education programmes. In both countries challenges for implementation included cooperation with stakeholders, communication, organisational aspects, attendance, human resources, and financing. Building the intervention around empowerment, to focus on culturally sensitive communication, to train health professionals and to actively involve the target group was found to be conducive for successful implementation. Conclusion: This study identified inter-country differences. Findings indicated consistent variables that are relevant to culturally sensitive education, although target groups differed. Overall, this study argues in favour of cultural tailoring, but highlights the risk of ethnicizing people during this process.