Health beliefs of African–Caribbean people with type 2 diabetes: a qualitative study

Background There is evidence that African–Caribbean people with diabetes have poorer outcomes than other individuals with diabetes. It is not fully understood why this happens.

Aim To gain an understanding of how health beliefs influence the way African–Caribbean people with diabetes manage their illness.

Design of study Qualitative study using one-to-one interviews.

Setting Inner-city Nottingham during 2003–2004.

Method A purposive sample of 16 African–Caribbean people with type 2 diabetes. Participants took part in semi-structured in-depth interviews which were audio-taped recorded and transcribed. Transcripts were analysed for emergent themes and validity was checked by an independent researcher and through discussion with a local community group. Data were managed using NVivo software.

Results Participants were strongly influenced by memories of growing up in the Caribbean, migration to the UK, and friends' and families' accounts of diabetes, as well as their own experiences of the illness. Knowledge and understanding of diabetes was sometimes poor. There was some mistrust in the value of advice and treatment offered by professionals and a preference for natural treatments. Health professionals were generally praised but some interviewees felt that the NHS did not cater properly for black people. Insulin treatments were feared and diet- or tablet-controlled diabetes was seen by some as a mild form that did not warrant serious concern.

Conclusions These findings have implications for how some people manage their diabetes and how diabetes care is delivered to the African–Caribbean community.