title: The relationships between illness and treatment perceptions with adherence to diabetes self-care: A comparison between Arabic-speaking migrants and Caucasian English-speaking patients.
abstract: OBJECTIVE
  To compare illness and treatment perceptions between Arabic-speaking immigrants and Caucasian English-speaking people with type 2 diabetes, and explore the relationships between these beliefs and adherence to self-care activities.
  
  
  METHODS
  A cross-sectional study was conducted in healthcare settings with large Arabic populations in metropolitan and rural Victoria, Australia. Adherence to self-care activities, illness and treatment perceptions, and clinical data were recorded. Bivariate associations for continuous normally distributed variables were tested with Pearson's correlation. Non-parametric data were tested using Spearman's rank correlation coefficient.
  
  
  RESULTS
  701 participants were recruited; 392 Arabic-speaking participants (ASPs) and 309 English-speaking participants (ESPs). There were significant relationships between participants' illness and treatment perceptions and adherence to diabetes self-care activities. ASPs' negative beliefs about diabetes were strongly and significantly correlated with poorer adherence to diet recommendations, exercise, blood glucose testing and foot care. ASPs were significantly less adherent to all aspects of diabetes self-care compared with ESPs: dietary behaviours (P=<0.01; 95% confidence interval (CI)=-1.17, -0.84), exercise and physical activity (P=<0.001, 95% CI -1.14, -0.61), blood glucose testing (P=<0.001) and foot-care (P=<0.001). 52.8% of ASPs were sceptical about prescribed diabetes treatment compared with only 11.2% of the ESPs. 88.3% of ASPs were non-adherent to prescribed medication, compared with 45.1% of ESPs.
  
  
  CONCLUSIONS
  Arabic-speaking migrants' illness and treatment perceptions were significantly different from the English-speaking group. There is a pressing need to develop new innovative interventions that deliver much-needed improvements in adherence to self-care activities and key health outcomes.
authors.affiliation: Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia. Electronic address: hamza.t.alzubaidy@monash.edu.
authors.forename: Hamzah
authors.initials: H
authors.lastname: Alzubaidi
authors.affiliation: Greater Green Triangle University, Department of Rural Health, Flinders University and Deakin University, PO Box 423, Warrnambool, Victoria 3280, Australia; Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Mc Narmara
authors.affiliation: Goulburn Valley Diabetes Centre, Goulburn Valley Health, Graham St., Shepparton, Victoria 3630, Australia; University of Melbourne, Faculty of Medicine, Dentistry and Health Science, Shepparton, Victoria 3630, Australia.
authors.forename: Gloria M
authors.initials: GM
authors.lastname: Kilmartin
authors.affiliation: Goulburn Valley Diabetes Centre, Goulburn Valley Health, Graham St., Shepparton, Victoria 3630, Australia; University of Melbourne, Faculty of Medicine, Dentistry and Health Science, Shepparton, Victoria 3630, Australia.
authors.forename: John F
authors.initials: JF
authors.lastname: Kilmartin
authors.affiliation: Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Marriott
mesh_terms: D000328:Adult; D000368:Aged; D018912:Arabs; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000628:therapy*; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D010465:Perception / Q000502:physiology*; D012648:Self Care / Q000379:methods*; D014171:Transients and Migrants; D014739:Victoria / Q000453:epidemiology; D044465:White People
keywords: Adherence; Arabic-speaking; Illness and treatment perceptions; Type 2 diabetes