Socio-cultural influences on the behaviour of South Asian women with diabetes in pregnancy: Qualitative study using a multi-level theoretical approachReport as inadecuate




Socio-cultural influences on the behaviour of South Asian women with diabetes in pregnancy: Qualitative study using a multi-level theoretical approach - Download this document for free, or read online. Document in PDF available to download.

Reference: Greenhalgh, T, Clinch, M, Afsar, N et al., (2015). Socio-cultural influences on the behaviour of South Asian women with diabetes in pregnancy: Qualitative study using a multi-level theoretical approach. BMC Medicine, 13 (1).Citable link to this page:

 

Socio-cultural influences on the behaviour of South Asian women with diabetes in pregnancy: Qualitative study using a multi-level theoretical approach

Abstract: BackgroundDiabetes in pregnancy is common in South Asians, especially those from low-income backgrounds, and leads to short-term morbidity and longer-term metabolic programming in mother and offspring. We sought to understand the multiple influences on behaviour (hence risks to metabolic health) of South Asian mothers and their unborn child, theorise how these influences interact and build over time, and inform the design of culturally congruent, multi-level interventions.MethodsOur sample for this qualitative study was 45 women of Bangladeshi, Indian, Sri Lankan, or Pakistani origin aged 21–45 years with a history of diabetes in pregnancy, recruited from diabetes and antenatal services in two deprived London boroughs. Overall, 17 women shared their experiences of diabetes, pregnancy, and health services in group discussions and 28 women gave individual narrative interviews, facilitated by multilingual researchers, audiotaped, translated, and transcribed. Data were analysed using the constant comparative method, drawing on sociological and narrative theories.ResultsKey storylines (over-arching narratives) recurred across all ethnic groups studied. Short-term storylines depicted the experience of diabetic pregnancy as stressful, difficult to control, and associated with negative symptoms, especially tiredness. Taking exercise and restricting diet often worsened these symptoms and conflicted with advice from relatives and peers. Many women believed that exercise in pregnancy would damage the fetus and drain the mother’s strength, and that eating would be strength-giving for mother and fetus. These short-term storylines were nested within medium-term storylines about family life, especially the cultural, practical, and material constraints of the traditional South Asian wife and mother role and past experiences of illness and healthcare, and within longer-term storylines about genetic, cultural, and material heritage–including migration, acculturation, and family memories of food insecurity. While peer advice was familiar, meaningful, and morally resonant, health education advice from clinicians was usually unfamiliar and devoid of cultural meaningConclusions‘Behaviour change’ interventions aimed at preventing and managing diabetes in South Asian women before and during pregnancy are likely to be ineffective if delivered in a socio-cultural vacuum. Individual education should be supplemented with community-level interventions to address the socio-material constraints and cultural frames within which behavioural ‘choices’ are made.

Peer Review status:Peer reviewedPublication status:PublishedVersion:Publisher's version Funder: European Framework 7   Funder: National Institute for Health Research   Notes:© 2015 Greenhalgh et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated

Bibliographic Details

Publisher: BMC Medicine

Publisher Website: http://biomedcentral.com/

Journal: BMC Medicinesee more from them

Publication Website: http://bmcmedicine.biomedcentral.com/

Issue Date: 2015-05Identifiers

Urn: uuid:faef937d-11d8-4cce-8b45-5b4ac71628ac

Source identifier: 528301

Eissn: 1741-7015

Doi: https://doi.org/10.1186/s12916-015-0360-1 Item Description

Type: Journal article;

Version: Publisher's versionKeywords: Diabetes Fetal programming Gestational diabetes Illness narrative Pregnancy Social ecology Tiny URL: pubs:528301

Relationships





Author: Greenhalgh, T - institutionUniversity of Oxford Oxford, MSD, Primary Care Health Sciences - - - Clinch, M - - - Afsar, N - - - Ch

Source: https://ora.ox.ac.uk/objects/uuid:faef937d-11d8-4cce-8b45-5b4ac71628ac



DOWNLOAD PDF




Related documents