Social Determinants Influencing the Non-Adoption of Norms Favorable to the Prevention and Control of Type 2 Diabetes: Qualitative Research

Abstract

Diet, physical activity, and body shape play an essential role in the development of type 2 diabetes (T2D) and are the social dimensions most targeted by health professionals in their practices or intervention aimed at preventing and controlling T2D. However, several interventions focus more on individual factors and less on social determinants likely to influence the adoption of dietary, body, and physical activity standards favorable to the prevention and control of T2D. This study aims to explore the social determinants influencing the rejection or adoption of dietary, bodily, and physical activity norms favorable to the prevention and control of T2D among migrants from sub-Saharan Africa. A qualitative exploratory design guided data collection and analysis. Semi-structured qualitative interviews and focus groups were conducted between October 2022 and March 2023 in Montreal and Quebec Cities. The cost of food, the difficulty of accessing certain foods, a reliable level of income, work schedules, the gazes of relatives or communities, migration policies, disappointment and stressful situations linked to migratory status, racial microaggressions, and the lack of food guides adapted to the realities of MASS were the main determinants identified by the participants. These determinants can influence the adoption of public health recommendations on diet for the prevention and control of T2D. People living with T2D obviously have an important role to play, but much of the work lies outside their control. Therefore, Preventive, clinical, or awareness-raising interventions should more consider the life and structural contexts in which these people navigate without ignoring their pre-migratory rules of dietary, body, and physical activity norms.