title: What are the barriers to primary prevention of type 2 diabetes in black and minority ethnic groups in the UK? A qualitative evidence synthesis.
abstract: BACKGROUND
  This review aimed to synthesise available qualitative evidence on barriers and facilitators to the implementation of community based lifestyle behaviour interventions to reduce the risk of diabetes in black and minority ethnic (BME) groups in the UK.
  
  
  METHODS
  A search of medical and social science databases was carried out and augmented by hand-searching of reference lists and contents of key journals. Qualitative evidence was synthesised thematically.
  
  
  RESULTS
  A total of 13 papers varying in design and of mainly good quality were included in the review. A limited number of intervention evaluations highlighted a lack of resources and communication between sites. A lack of understanding by providers of cultural and religious requirements, and issues relating to access to interventions for users was reported. Behaviour change was impeded by cultural and social norms, and resistance to change. There were variations in the way dietary change and physical activity was approached by different groups and contrasting practices between generations.
  
  
  CONCLUSIONS
  Qualitative data provided insight into the ways that providers might improve or better design future interventions. Acknowledgement of the way that different groups approach lifestyle behaviours may assist acceptability of interventions.
authors.affiliation: University of Sheffield, School of Health and Related Research, Sheffield, South Yorkshire S1 4DA, United Kingdom. Electronic address: m.johnson@sheffield.ac.uk.
authors.forename: Maxine
authors.initials: M
authors.lastname: Johnson
authors.affiliation: University of Sheffield, School of Health and Related Research, Sheffield, South Yorkshire S1 4DA, United Kingdom.
authors.forename: Emma
authors.initials: E
authors.lastname: Everson-Hock
authors.affiliation: University of Sheffield, School of Health and Related Research, Sheffield, South Yorkshire S1 4DA, United Kingdom.
authors.forename: Roy
authors.initials: R
authors.lastname: Jones
authors.affiliation: University of Sheffield, School of Health and Related Research, Sheffield, South Yorkshire S1 4DA, United Kingdom.
authors.forename: Helen Buckley
authors.initials: HB
authors.lastname: Woods
authors.affiliation: University of Sheffield, School of Health and Related Research, Sheffield, South Yorkshire S1 4DA, United Kingdom.
authors.forename: Nick
authors.initials: N
authors.lastname: Payne
authors.affiliation: University of Sheffield, School of Health and Related Research, Sheffield, South Yorkshire S1 4DA, United Kingdom.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Goyder
mesh_terms: D003142:Communication; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000517:prevention & control*; D006297:Health Services Accessibility; D006801:Humans; D008019:Life Style; D008913:Minority Groups; D011322:Primary Prevention; D006113:United Kingdom