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ORIGINAL RESEARCH article

Front. Public Health
Sec. Public Health Education and Promotion
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1508204

Factors Influencing Type 2 Diabetes Self-Management Practices in Rural Bangladesh: A

Provisionally accepted
Hasina Akhter Chowdhury Hasina Akhter Chowdhury 1,2Md Billah Md Billah 1Shamia Akther Dipa Shamia Akther Dipa 3Ashraful Kabir Ashraful Kabir 1A K M Fazlur Rahman A K M Fazlur Rahman 2Liaquat Ali Liaquat Ali 4Anju Joham Anju Joham 5,6Cheryce L Harrison Cheryce L Harrison 1,6*
  • 1 School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia
  • 2 Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Dhaka, Bangladesh
  • 3 Centre for Qualitative Research, Dhaka, Bangladesh
  • 4 Pothikrit Institute of Health Studies (PIHS), Dhaka, Bangladesh
  • 5 Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, Victoria, Australia
  • 6 Department of Diabetes, Monash University, Melbourne, Victoria, Australia

The final, formatted version of the article will be published soon.

    Introduction: Type 2 diabetes mellitus (T2DM) is a prevalent, chronic health condition of global significance, with low-and middle-income countries (LMICs) disproportionately affected. Diabetes self-management practices (DSMP) are the gold-standard treatment approach, yet uptake remains challenge in LMICs.This study aimed to explore the barriers to and facilitators of DSMP and preferences for intervention design and delivery in Bangladesh, an LMIC, with prevalent T2DM.Methods: Sixteen qualitative focus group discussions (FGDs) with adults with T2DM and their caregivers were conducted in rural Bangladesh to explore preferences, barriers, and facilitators for community DSMP-related intervention programs. Data were thematically analysed using a deductive theoretical domains framework (TDF) underpinned by the socio-ecological model.Overall, 117 participants (n = 58 with T2DM and n = 59 caregivers) were included in the analysis. Five overarching themes were identified, including (i) implementation of DSMP, (ii) community spirit and interconnectedness, (iii) environmental influences, (iv) healthcare professionals' role in DSMP, and (v) government support. Key barriers to DSMP identified for T2DM patients include knowledge implementation gaps, cultural practices, limited resources, and financial constraints. Facilitators include motivation, support from family and peers, and religious practices. Rural Bangladeshis prefer programs delivered at community clinics, viewing them as reliable, culturally appropriate central 'hubs' to assemble.Barriers to and facilitators of DSMP were identified, and preferences for intervention design and delivery for implementing DSMP were explored. The findings provide a foundation for the critical need to implement programs that improve DSMP in Bangladesh, with the potential to translate to other LMIC settings.

    Keywords: barriers, Facilitators, Diabetes self-management practices, type 2 diabetes mellitus, rural Bangladesh, qualitative study

    Received: 09 Oct 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Chowdhury, Billah, Dipa, Kabir, Rahman, Ali, Joham and Harrison. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Cheryce L Harrison, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, 3004, Victoria, Australia

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.