title: The use of focus groups as a basis for planning and implementing culturally appropriate health promotion among people with diabetes in the Arab community.
abstract: OBJECTIVE
  The main study objective was to identify perceived barriers to achieving glycemic control among the Arab population in Israel, by both members of the Arab community with type 2 diabetes and by primary care teams working with the Arab community.
  
  
  METHODS
  A series of six focus groups using qualitative research methodology were conducted in two phases among people with diabetes and primary care professionals treating them.
  
  
  RESULTS
  The perception of the disease among people with diabetes was one of low severity. Barriers to adopting a healthy lifestyle and to self-management included awareness of the need, financial considerations regarding medication, and traditional gender roles. Food preparation in family life was identified as a strong cultural determinant. The health literacy needs for more in-depth and accessible educational programs were identified. Primary care staff viewed the needs similarly, with the exception of the need for in-depth instructional materials.
  
  
  CONCLUSIONS
  The understanding of the significance of healthy lifestyles and self-management was essential for developing culturally appropriate implementation programs and policy. Consultation with, and involvement of patient groups in needs assessment and planning is essential and should be established in policy that promotes best practice and health promotion in chronic illness.
authors: Department of Health Education and Promotion, Clalit Health Services, Israel School of Public Health, University of Haifa, Israel dianele@clalit.org.il.
authors: Diane
authors: D
authors: Levin-Zamir
authors: Northern District, Clalit Health Services, Israel.
authors: Siham
authors: S
authors: Badarne
authors: Haifa District, Clalit Health Services, Israel.
authors: Muhamed
authors: M
authors: Najami
authors: Central Office, Clalit Health Services, Israel.
authors: Shosh
authors: S
authors: Gan Noy
authors: Central Office, Clalit Health Services, Israel.
authors: Irit
authors: I
authors: Poraz
authors: Central Office, Clalit Health Services, Israel.
authors: Menachem
authors: M
authors: Shapira
authors: Central Office, Clalit Health Services, Israel.
authors: Nicky
authors: N
authors: Lieberman
authors: Central Office, Clalit Health Services, Israel Technion Medical School, Israel.
authors: Margalit
authors: M
authors: Goldfracht
mesh_terms: D018912:Arabs / Q000523:psychology; D001291:Attitude of Health Personnel; D015190:Blood Glucose Self-Monitoring / Q000523:psychology / Q000592:standards*; D003296:Cooking; D065246:Culturally Competent Care / Q000208:ethnology / Q000592:standards*; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D015444:Exercise; D005260:Female; D017144:Focus Groups; D005783:Gender Identity; D057220:Health Literacy; D006293:Health Promotion / Q000379:methods / Q000592:standards*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D020380:Needs Assessment; D011320:Primary Health Care / Q000379:methods / Q000592:standards*; D036301:Qualitative Research
keywords: community; empowerment; health literacy; health promotion; management; minorities; non-communicable disease; program planning; research methods