a Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden.
b Department of Food Studies, Nutrition, and Dietetics , Uppsala University , Uppsala , Sweden.
Glob Health Action. 2019;12(1):1609313. doi: 10.1080/16549716.2019.1609313.
: Community-based approaches have been identified as an effective strategy to address the growing burden of noncommunicable diseases (NCDs) worldwide. However, little is known about community as a concept among people living in socioeconomically disadvantaged settings and stakeholders' interactions and engagement in NCDs prevention and management. : The aim of this study was to understand; (1) the meaning of community among people living in socioeconomically disadvantaged suburbs in Region Stockholm and (2) how communities interact and engage with stakeholders at local and regional levels for the prevention and management of type 2 diabetes (T2D). : This qualitative study was conducted in three municipalities in Region Stockholm with a high proportion of migrants. Multiple data collection methods were used, including observations of community activities; interviews with community members, representatives of public authorities and NGOs; and group interviews with healthcare providers. Data were analyzed using content analysis. : Community was perceived as living in close proximity with shared beliefs, values and resources. Although they recognized its social and cultural diversity, community members focused more on the commonalities of living in their neighborhood and less on their differences in country of birth and languages spoken. Several mismatches between awareness of community needs and the available skills and resources among stakeholders for T2D prevention were identified. Stakeholders expressed awareness of T2D risk and interest in addressing it in a culturally appropriate manner. : Interaction between the communities and stakeholders was limited, as was engagement in T2D prevention and management. This highlights barriers in the collaboration between community, healthcare institutions and other stakeholders which consequently affect the implementation of preventive interventions. Innovative ways to link the community to the healthcare sector and other local government institutions are needed to build the capacity of health systems for T2D prevention in socioeconomically disadvantaged communities.
以社区为基础的方法已被确定为应对全球不断增加的非传染性疾病(NCD)负担的有效策略。然而,对于生活在社会经济处于不利地位的环境中的人们以及利益攸关方在 NCD 预防和管理中的相互作用和参与,人们对社区作为一个概念知之甚少。本研究旨在了解:(1)生活在斯德哥尔摩地区社会经济处于不利地位的郊区的人们对社区的理解;(2)社区如何与地方和区域各级的利益攸关方互动和参与,以预防和管理 2 型糖尿病(T2D)。本定性研究在斯德哥尔摩地区的三个有大量移民的城市进行。使用了多种数据收集方法,包括观察社区活动;对社区成员、公共当局和非政府组织代表进行访谈;以及与医疗保健提供者进行小组访谈。使用内容分析法分析数据。社区被认为是生活在附近的、具有共同信仰、价值观和资源的人。尽管他们认识到社区的社会和文化多样性,但社区成员更关注他们在邻里生活中的共同点,而较少关注他们在原籍国和语言方面的差异。在 T2D 预防方面,利益攸关方对社区需求的认识与其可用于预防 T2D 的技能和资源之间存在一些不匹配。利益攸关方意识到 T2D 的风险,并有意以文化上适当的方式解决这一问题。社区与利益攸关方之间的互动有限,参与 T2D 的预防和管理也有限。这突出了社区、医疗保健机构和其他利益攸关方之间合作的障碍,从而影响了预防干预措施的实施。需要创新的方式将社区与医疗保健部门和其他地方政府机构联系起来,以增强卫生系统预防 T2D 的能力。