title: Theory that explains an Aboriginal perspective of learning to understand and manage diabetes.
abstract: OBJECTIVE
  To use grounded theory and participatory research methodology to explain how Aboriginal people learn to understand and manage type 2 diabetes.
  
  
  METHODS
  Aboriginal people with diabetes were invited to participate in one of five focus groups (n=25, male=12, female=13). Focus groups and education sessions were conducted by Aboriginal members of the research team. Focus groups were audio recorded and transcribed, with coding and first level analysis undertaken by all members of the research team.
  
  
  RESULTS
  Participants described colonisation and dislocation from Country and family members' experiences with diabetes as significant historical influences which, in conjunction with the model of care experienced and the type of interaction with health services, shaped how they came to understand and manage their diabetes.
  
  
  CONCLUSIONS
  Patient experience of a model of care alone is not what influences understanding and management of diabetes in Aboriginal people. Implications for Public Health: Health service improvements should focus on understanding past experiences of Aboriginal patients, improving interactions with health services and supporting holistic family centred models of care. Focusing on just the model of care in absence of other improvements is unlikely to deliver health benefits to Aboriginal people.
authors.affiliation: School of Rural Health, University of Sydney, New South Wales.
authors.forename: Emma
authors.initials: E
authors.lastname: Webster
authors.affiliation: Western NSW Local Health District, New South Wales.
authors.forename: Craig
authors.initials: C
authors.lastname: Johnson
authors.affiliation: Dubbo Regional Aboriginal Health Service, New South Wales.
authors.forename: Bernie
authors.initials: B
authors.lastname: Kemp
authors.affiliation: Dubbo Regional Aboriginal Health Service, New South Wales.
authors.forename: Valerie
authors.initials: V
authors.lastname: Smith
authors.affiliation: Marathon Health, New South Wales.
authors.forename: Monica
authors.initials: M
authors.lastname: Johnson
authors.affiliation: School of Rural Health, University of Sydney, New South Wales.
authors.forename: Billie
authors.initials: B
authors.lastname: Townsend
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055812:Community-Based Participatory Research; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000523:psychology* / Q000628:therapy; D019468:Disease Management; D005260:Female; D017144:Focus Groups; D066296:Grounded Theory; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D036301:Qualitative Research
keywords: Aboriginal health; diabetes models of care; integrated care; participatory research methods