title: Perspectives of UK Pakistani women on their behaviour change to prevent type 2 diabetes: qualitative study using the theory domain framework.
abstract: BACKGROUND
  Type 2 diabetes (T2D) is a debilitating disease, highly prevalent in UK South Asians, and preventable by lifestyle intervention. The 'New life, New you' (NLNY) physical activity (PA) and dietary intervention for T2D prevention was culturally adapted to better engage minority ethnic populations and tested for feasibility.
  
  
  OBJECTIVE
  To investigate Pakistani female participants' perspectives of their behaviour change and of salient intervention features.
  
  
  METHODS
  A community-based 8-week programme of group delivered PA sessions with behavioural counselling and dietary advice, culturally adapted for ethnic minority populations, in an area of socioeconomic deprivation. Participants to NLNY were recruited through screening events in community venues across the town.
  
  
  METHODS
  Interviews were conducted with 20 Pakistani female NLNY participants, aged 26-45 (mean 33.5) years, from different parts of town.
  
  
  RESULTS
  Within the a priori Theoretical Domains Framework (intentions and goals, reinforcement, knowledge, nature of the activity, social role and identity, social influences, capabilities and skills, regulation and decision, emotion and environment), we identified the importance of social factors relating to participants' own PA and dietary behaviour change. We also identified cross-cutting themes as collateral benefits of the intervention including participants' 'psychological health'; 'responsibility' (for others' health, especially family members included in the new PA and diet regimes) and 'inclusion' (an ethos of accommodating differences).
  
  
  CONCLUSIONS
  Our findings suggest that culturally adapted interventions for Pakistani women at risk of T2D, delivered via group PA sessions with counselling and dietary advice, may encourage their PA and dietary behaviour change, and have collateral health and social benefits. The NLNY intervention appeared to be acceptable. We plan to evaluate recruitment, retention and likely effect of the intervention on participant behaviour prior to definitive evaluation.
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK Fuse, UKCRC Centre for Translational Research in Public Health.
authors.forename: Linda
authors.initials: L
authors.lastname: Penn
authors.affiliation: Division of Psychology, School of Natural Sciences, University of Stirling, Stirling, UK.
authors.forename: Stephan U
authors.initials: SU
authors.lastname: Dombrowski
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK Fuse, UKCRC Centre for Translational Research in Public Health.
authors.forename: Falko F
authors.initials: FF
authors.lastname: Sniehotta
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK Fuse, UKCRC Centre for Translational Research in Public Health.
authors.forename: Martin
authors.initials: M
authors.lastname: White
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003376:Counseling / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000517:prevention & control* / Q000523:psychology; D004032:Diet / Q000379:methods*; D005006:Ethnicity; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D010154:Pakistan / Q000208:ethnology; D015995:Prevalence; D036301:Qualitative Research; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: Health Services Administration & Management; Preventive Medicine; Public Health; Qualitative Research