Everybody’s business: Self-management of diabetes among a cohort of culturally and linguistically diverse individuals in regional Australia

"In spite of various health care initiatives, diabetes self-management among culturally and linguistically diverse (CALD) migrant Australians is poor. This improper diabetes self-management is becoming a burden on the Australian economy. The literature review of this thesis also suggests that while individual attributes such as knowledge, beliefs, attitudes and demographics impact on self-management of diabetes, collaboration of different levels of influences, from immediate family members to health policy makers are mandatory. Such a collaborative effort can be supported by existing models of health promotion based on socio-ecological theory. In Australia very few socio-ecological theory based studies were reported in terms of the knowledge, self-care activities and experiences about diabetes self-management among CALD people. Particularly, to date no such study has conveyed the voices of the CALD people living with diabetes in regional Australia. Therefore, this study has been conducted in a regional setting and twenty-nine (29) CALD males and females from a regional area participated in this study. For the data collection and data analysis of this study I have chosen a mixed methods approach under the interpretive-constructivist paradigm. The study found that demographics such as age, education, level of English proficiency, and cultural factors such as traditional food, values, beliefs, language and socio-structural factors such as provision of health education, play a significant role in diabetes self-management among this cohort. Further, the socio-culturally constructed role of gender is found to be an overarching issue in diabetes self-management which determines the efficiency of diabetes self-management among the CALD women in this study. It is recommended that health service providers should be sensitive to the needs and barriers of CALD female individuals living with diabetes. Moreover, the study suggests that the problem of diabetes self-management need to be addressed by health care services, in terms of social, cultural and environmental influences surrounding an individual. However, these health service consumers also need to be informed of the culture and health care service system in the host1 country. Therefore, in addition to multi-level support, this study advocates that reciprocal knowing between health service providers and the consumers is an essential element for successful self-management of diabetes among these people. Particularly, this reciprocal knowing is vital in a regional context, where absolutely culturally competent health service provision is not feasible for a small but heterogeneous CALD migrant population. The sample size and time within which the study was undertaken, did not allow significant quantitative explorations as well as further qualitative inquiries about different levels of influence for diabetes self-management. The mixed methods approach and use of participants’ actual voices as data provide an evidentiary basis for further research opportunities in this area."--Abstract.