1
|
Deveci AC, Gurnani M, Wolfe-Wylie MC, Regina A, Cordeiro K, Dave MG, Mahmud FH, Hamilton J. Looking at Diabetes Through Different Lenses: Focus Groups Conducted With Somali Canadian Families and Their Health-care Providers. Can J Diabetes 2024; 48:112-119.e3. [PMID: 38056690 DOI: 10.1016/j.jcjd.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/16/2023] [Accepted: 11/25/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVES In Toronto, many families with Somali backgrounds have children living with type 1 diabetes (T1D). At our clinic, children with African and Caribbean backgrounds have higher glycated hemoglobin than children from European backgrounds. In this study, we explored the experiences and perspectives of Somali Canadian families with children living with T1D, as well as health-care professionals (HCPs) who care for them, to better understand how T1D impacts these families. METHODS We conducted 3 separate focus groups with Somali Canadian parents of children with T1D (n=11), Somali Canadian adolescents with T1D (n=5), and HCPs who treat patients with diabetes (n=9), respectively. A grounded theory approach to data analysis was applied to identify themes. RESULTS Four key themes emerged: 1) the general impact of living with diabetes, 2) the challenges of self-management, 3) uncertainty on whose job it is to manage the diabetes, and 4) how cultural differences between Canada and Somalia impact diabetes management. There was discordance in the perspectives of families and HCPs for all themes, but especially themes 1 and 3. Parents focussed on the social impact of diabetes and behavioural indicators of management success, whereas HCPs emphasized clinical measures. Families believed children should take charge of their diabetes self-management early on, whereas HCPs believed the children were not developmentally ready for this responsibility. CONCLUSIONS Differing perspectives of patients, families, and HCPs may lead to diverging expectations for treatment and management. Families and practitioners must work together to identify barriers to care and build strategies to promote competency and resilience in the self-management of T1D.
Collapse
Affiliation(s)
- Arin C Deveci
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Muskaan Gurnani
- University of Toronto, Toronto, Ontario, Canada; McMaster University, Hamilton, Ontario, Canada
| | - Margaret C Wolfe-Wylie
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada; Neonatal & Paediatric Medicine, Orillia Soldiers' Memorial Hospital, Orillia, Ontario, Canada
| | - Andrea Regina
- University of Toronto, Toronto, Ontario, Canada; Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kristina Cordeiro
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychology, York University, Toronto, Ontario, Canada
| | - Malini G Dave
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada; Black Creek Community Health Centre, Toronto, Ontario, Canada
| | - Farid H Mahmud
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada
| | - Jill Hamilton
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
2
|
Nicolae A, Levin L, Wong PD, Dave MG, Taras J, Mistry C, Ford-Jones EL, Wong M, Schroth RJ. Identification of early childhood caries in primary care settings. Paediatr Child Health 2018; 23:111-115. [PMID: 29686495 PMCID: PMC5905494 DOI: 10.1093/pch/pxx155] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Early childhood caries (ECC) is the most common chronic disease affecting young children in Canada. ECC may lead to pain and infection, compromised general health, decreased quality of life and increased risk for dental caries in primary and permanent teeth. A multidisciplinary approach to prevent and identify dental disease is recommended by dental and medical national organizations. Young children visit primary care providers at regular intervals from an early age. These encounters provide an ideal opportunity for primary care providers to educate clients about their children's oral health and its importance for general health. We designed an office-based oral health screening guide to help primary care providers identify ECC, a dental referral form to facilitate dental care access and an oral health education resource to raise parental awareness. These resources were reviewed and trialled with a small number of primary care providers.
Collapse
Affiliation(s)
| | - Leo Levin
- Social Pediatrics, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario
- The Children’s Aid Society, Toronto, Ontario
| | - Peter D Wong
- SickKids Research Institute, Toronto, Ontario
- Division of Paediatric Medicine, Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Malini G Dave
- Black Creek Community Health Centre, Toronto, Ontario
- Emergency Medicine, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Ontario
| | - Jillian Taras
- Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Chetna Mistry
- Faculty of Dentistry, University of Toronto, Toronto, Ontario
| | - Elizabeth L Ford-Jones
- Social Pediatrics, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario
- Division of Paediatric Medicine, Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario
| | | | - Robert J Schroth
- Department of Preventive Dental Science, College of Dentistry, University of Manitoba, Winnipeg, Manitoba
- Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba
| |
Collapse
|
3
|
Wong PD, Dave MG, Tulloch T, Feldman ML, Ford-Jones EL, Parkin PC, Tetley A, Moodie RG. Community health centres: Potential opportunities for community paediatrics. From interprofessional clinical care to board governance. Paediatr Child Health 2015; 20:12-4. [PMID: 25722635 DOI: 10.1093/pch/20.1.12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peter D Wong
- Rexdale Community Health Centre; ; Community Paediatrics, Division of Paediatric Medicine, Department of Paediatrics, University of Toronto
| | - Malini G Dave
- Black Creek Community Health Centre; ; Emergency Medicine, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto
| | - Trisha Tulloch
- Barbara Black Community Health Centre, Ajax; ; Concurrent Youth Unit, Centre for Addiction and Mental Health, Department of Paediatrics, University of Toronto
| | - Mark L Feldman
- Continuing Education, Department of Paediatrics; ; Community Paediatrics and Integrated Medical Education; ; Faculty of Medicine, University of Toronto, The Hospital for Sick Children & Saint Joseph's Health Centre
| | | | - Patricia C Parkin
- The Applied Research Group for Kids (TARGetKids!); ; Paediatric Outcomes Research Team, Department of Paediatrics, Hospital for Sick Children
| | | | - Rosemary G Moodie
- Division of Neonatology, Department of Paediatrics, University of Toronto, Toronto, Ontario
| |
Collapse
|