Looking at Diabetes Through Different Lenses: Focus Groups Conducted With Somali Canadian Families and Their Health-care Providers

Arin C Deveci; Muskaan Gurnani; Margaret C Wolfe-Wylie; Andrea Regina; Kristina Cordeiro; Malini G Dave; Farid H Mahmud; Jill Hamilton

doi:10.1016/j.jcjd.2023.11.004

Looking at Diabetes Through Different Lenses: Focus Groups Conducted With Somali Canadian Families and Their Health-care Providers

Can J Diabetes. 2024 Mar;48(2):112-119.e3. doi: 10.1016/j.jcjd.2023.11.004. Epub 2023 Dec 5.

Authors

Arin C Deveci¹, Muskaan Gurnani², Margaret C Wolfe-Wylie³, Andrea Regina⁴, Kristina Cordeiro⁵, Malini G Dave⁶, Farid H Mahmud⁷, Jill Hamilton⁸

Affiliations

¹ Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada.
² University of Toronto, Toronto, Ontario, Canada; McMaster University, Hamilton, Ontario, Canada.
³ Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada; Neonatal & Paediatric Medicine, Orillia Soldiers' Memorial Hospital, Orillia, Ontario, Canada.
⁴ University of Toronto, Toronto, Ontario, Canada; Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁵ Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychology, York University, Toronto, Ontario, Canada.
⁶ Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada; Black Creek Community Health Centre, Toronto, Ontario, Canada.
⁷ Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
⁸ Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada. Electronic address: jill.hamilton@sickkids.ca.

PMID: 38056690
DOI: 10.1016/j.jcjd.2023.11.004

Abstract

Objectives: In Toronto, many families with Somali backgrounds have children living with type 1 diabetes (T1D). At our clinic, children with African and Caribbean backgrounds have higher glycated hemoglobin than children from European backgrounds. In this study, we explored the experiences and perspectives of Somali Canadian families with children living with T1D, as well as health-care professionals (HCPs) who care for them, to better understand how T1D impacts these families.

Methods: We conducted 3 separate focus groups with Somali Canadian parents of children with T1D (n=11), Somali Canadian adolescents with T1D (n=5), and HCPs who treat patients with diabetes (n=9), respectively. A grounded theory approach to data analysis was applied to identify themes.

Results: Four key themes emerged: 1) the general impact of living with diabetes, 2) the challenges of self-management, 3) uncertainty on whose job it is to manage the diabetes, and 4) how cultural differences between Canada and Somalia impact diabetes management. There was discordance in the perspectives of families and HCPs for all themes, but especially themes 1 and 3. Parents focussed on the social impact of diabetes and behavioural indicators of management success, whereas HCPs emphasized clinical measures. Families believed children should take charge of their diabetes self-management early on, whereas HCPs believed the children were not developmentally ready for this responsibility.

Conclusions: Differing perspectives of patients, families, and HCPs may lead to diverging expectations for treatment and management. Families and practitioners must work together to identify barriers to care and build strategies to promote competency and resilience in the self-management of T1D.

Keywords: Somalia; Somalie; adolescent; child; diabetes mellitus; diabète de type 1; diabète sucré; enfant; ethnic and racial minorities; minorités ethniques et raciales; type 1 diabetes.

MeSH terms

Adolescent
Canada / epidemiology
Child
Diabetes Mellitus, Type 1* / therapy
Focus Groups
Health Personnel
Humans
Somalia