Paper short abstract:

Drawing on a qualitative study aiming to culturally adapt a diabetes self-management programme for patients with diabetes in Saudi Arabia, this paper discusses how the idea of ‘culture’ was generally used by patients and clinicians to justify the inadequate adoption of self-management behaviours.

Paper long abstract:

Self-management is an integral part of chronic disease management. Diabetes self-management programmes have shown to be effective. However, they are not standard practice in all high prevalence settings. For example, although the prevalence of Type 2 Diabetes in Saudi Arabia is 23%, such programmes have yet to be developed and deployed to serve this population. Self-management programmes are highly culturally and context specific, requiring substantial research and refinement to make them effective. This paper reports on how the well regarded Stanford Diabetes Self-Management Programme was culturally adapted for Saudi patients. A total of 39 participants were recruited from clinic settings to attend the six week programme and their feedback was used to inform the adaptation. A qualitative study of this process and of experiences of diabetes was built into the programme. This consisted of informal discussions with medical staff in clinics and a series of focus groups with participating patients to explore perceptions of the programme and barriers to self-management. These were audio-recorded, transcribed verbatim and thematically analysed. One striking set of findings that emerged from the analysis were the ways in which the idea of 'culture' was widely used by both patients and medics to refute expectations of self-management and thereby justify practices deemed 'unhealthy'. These findings can help inform the effective cultural adaptation of self-management programmes.