Voices of those living with type 2 diabetes in Belize: barriers to care before and during the COVID-19 pandemic.


Journal

International journal for equity in health
ISSN: 1475-9276
Titre abrégé: Int J Equity Health
Pays: England
ID NLM: 101147692

Informations de publication

Date de publication:
24 08 2023
Historique:
received: 20 06 2022
accepted: 14 08 2023
medline: 28 8 2023
pubmed: 25 8 2023
entrez: 24 8 2023
Statut: epublish

Résumé

Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America, and fifth direst in the world. T2D is the leading cause of death in Belize, a country facing burdens of increasing prevalence with few resources. Since March of 2020, the COVID-19 pandemic has exacerbated the difficulties of those living with T2D in Belize. To address T2D issues in Belize, our interdisciplinary research team explored the barriers to care and self-management for adult patients with T2D in Belize prior to and during the COVID-19 pandemic.Research relationships between Canadian (ARH) and Belizean (LE) authors have been ongoing since 2016. Together we used a qualitative Constructivist Grounded Theory design generating knowledge through 35 semi-structured patient interviews, 25 key informant discussions, and participant observation with field notes between February 2020 to September 2021. We used Dedoose analysis software for a systematized thematic coding process, as well as iterative verification activities. Findings revealed several barriers to care and self-management, including: 1) the tiered health and social care system with major gaps in coverage; 2) the unfulfilled demand for accurate health information and innovative dissemination methods; and 3) the compounding of loss of community supports, physical exercise, and health services due to COVID-19 restrictions. In the post-pandemic period, it is necessary to invest in physical, nutritional, economic, and psychosocial health through organized activities adaptable to changeable public health restrictions. Recommendations for activities include sending patients informational and motivational text messages, providing recipes with accessibly sourced T2D foods, televising educational workshops, making online tools more accessible, and mobilising community and peer support networks.

Identifiants

pubmed: 37620814
doi: 10.1186/s12939-023-01987-3
pii: 10.1186/s12939-023-01987-3
pmc: PMC10463824
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

163

Subventions

Organisme : CIHR
ID : FRN 130797
Pays : Canada

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

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Auteurs

Lindsay P Allen (LP)

Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, 221 Human Ecology Bldg, Winnipeg, MB, R3T 2N2, Canada.

Lucia Ellis (L)

Belize Diabetes Association, Belize City, Belize.

Christophe Engleton (C)

Belize Diabetes Association, Belize City, Belize.

Valerie Lynette Valerio (VL)

Belize Diabetes Association, Belize City, Belize.

Andrew R Hatala (AR)

Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, 221 Human Ecology Bldg, Winnipeg, MB, R3T 2N2, Canada. andrew.hatala@umanitoba.ca.

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