Barriers and Facilitators to Implementing Food is Medicine for the Management of Type 2 Diabetes in China.

Background: 'Food is Medicine', a rapidly growing innovative intervention, has been shown to improve the management of type 2 diabetes mellitus (T2DM). However, due to the unique characteristics of Chinese dietary culture, it remains unclear whether such intervention measures can be implemented in China.

Objective: To identify the potential barriers and facilitators to implementing 'Food is Medicine' intervention for the management of people living with T2DM in three Chinese provinces.

Design: Face-to-face semi-structured individual in-depth interview and focus group discussions in Heilongjiang, Hubei and Ningxia provinces in China.

Participant: People living with T2DM.

Approach: Both inductive and deductive methods were used to analyse the interview data, guided by the COM-B framework.

Key results: A total of 97 individuals participated in the study. Participants were concerned about the prices of buying prescribed meals, if not fully subsidised by healthcare system. Other barriers included the potential challenge to adhering to prescribed meals for long periods if the variety was limited, the difficulties in delivering fresh food or meals to remote areas and the lack of knowledge of healthy diets among the people living with T2DM and their relatives. In contrast, clinicians' confidence in the effectiveness of food and meal prescription, the opportunities to collaborate with community canteens on producing prescribed foods, and the convenience of preparing food for people with T2DM were identified as the main enablers.

Conclusions: There are presently several potential barriers to future implementing 'Food is Medicine' to manage people living with T2DM. But there are also clear opportunities to develop a context-tailored 'Food is Medicine' intervention in China.