title: Illness beliefs and the sociocultural context of diabetes self-management in British South Asians: a mixed methods study.
abstract: BACKGROUND
  British South Asians have a higher incidence of diabetes and poorer health outcomes compared to the general UK population. Beliefs about diabetes are known to play an important role in self-management, yet little is known about the sociocultural context in shaping beliefs. This study aimed to explore the influence of sociocultural context on illness beliefs and diabetes self-management in British South Asians.
  
  
  METHODS
  A mixed methods approach was used. 67 participants recruited using random and purposive sampling, completed a questionnaire measuring illness beliefs, fatalism, health outcomes and demographics; 37 participants completed a social network survey interview and semi-structured interviews. Results were analysed using SPSS and thematic analysis.
  
  
  RESULTS
  Quantitative data found certain social network characteristics (emotional and illness work) were related to perceived concern, emotional distress and health outcomes (p < 0.05). After multivariate analysis, emotional work remained a significant predictor of perceived concern and emotional distress related to diabetes (p < 0.05). Analysis of the qualitative data suggest that fatalistic attitudes and beliefs influences self-management practices and alternative food 'therapies' are used which are often recommended by social networks.
  
  
  CONCLUSIONS
  Diabetes-related illness beliefs and self-management appear to be shaped by the sociocultural context. Better understanding of the contextual determinants of behaviour could facilitate the development of culturally appropriate interventions to modify beliefs and support self-management in this population.
authors.affiliation: Centre for Endocrinology and Diabetes and Manchester Centre for Health Psychology, Institute of Human Development, The University of Manchester, Room S42, Second Floor, Zochonis Building, Brunswick Street, Manchester, M13 9PT, UK. Neesha.patel-2@manchester.ac.uk.
authors.forename: Neesha R
authors.initials: NR
authors.lastname: Patel
authors.affiliation: Primary Care and Health Sciences, and NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) West Midlands, Research Institute, Keele University, Keele, Staffordshire, ST5 5BG, UK. c.a.chew-graham@keele.ac.uk.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Chew-Graham
authors.affiliation: Institute for Inflammation and Repair, The University of Manchester, 1.530 Stopford Building, Oxford Road, Manchester, M13 9PL, UK. Christine.bundy@manchester.ac.uk.
authors.forename: Christine
authors.initials: C
authors.lastname: Bundy
authors.affiliation: NIHR CLAHRC Wessex, Faculty of Health Sciences, Building 67, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, UK. A.Kennedy@soton.ac.uk.
authors.forename: Anne
authors.initials: A
authors.lastname: Kennedy
authors.affiliation: NIHR CLAHRC Greater Manchester, The University of Manchester, Centre for Primary Care, 5th Floor Williamson Building, Oxford Road, Manchester, M13 9PL, UK. Christian.blickem@manchester.ac.uk.
authors.forename: Christian
authors.initials: C
authors.lastname: Blickem
authors.affiliation: Centre for Primary Care, The University of Manchester, 5th Floor Williamson Building, Oxford Road, Manchester, M13 9PL, UK. David.reeves@manchester.ac.uk.
authors.forename: David
authors.initials: D
authors.lastname: Reeves
mesh_terms: D000328:Adult; D044466:Asian People / Q000523:psychology; D003431:Cross-Cultural Comparison; D003469:Culture; D003920:Diabetes Mellitus / Q000208:ethnology / Q000523:psychology / Q000628:therapy; D005006:Ethnicity; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology