Banerjee Ananya Tina, Islam Shudipta, Khan Amina, Hussain Nousin, Ascencio Evelyn, Hafleen Nuzha
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Can J Diabetes. 2024 Mar;48(2):97-104.e3. doi: 10.1016/j.jcjd.2023.11.002. Epub 2023 Nov 10.
The higher prevalence of diabetes in the South Asian (SA) population living in Canada spans across generations and is often associated with individual risk factors while undermining the social determinants of health (SDOH). There is a scarcity of studies on the perspectives of SA adolescents with a family history of type 2 diabetes mellitus (T2DM). Learning directly from these adolescents can fill a major gap by providing insight on how the SDOH contribute to disproportionate rates of T2DM in SA immigrant communities.
In this study, we used Photovoice, which is a community-based participatory research (CBPR) method that involves the use of photography to visually capture the challenges of diabetes prevention from the perspective of those with lived experiences. A group of 15 SA youth were recruited from an adolescent diabetes education program in the Peel Region of Ontario. The youth discussed their images and accompanied written narratives during focus groups.
Four themes emerged from the thematic analysis of the photographs and participant narratives that influence the manifestation of T2DM in SA communities: 1) immigration and resettlement stressors; 2) food insecurity; 3) unhealthy school environments; and 4) academic pressures.
Findings suggest the need to address T2DM as a response to unjust conditions and environments rather than as an epidemic entrenched in genetic predisposition, culture, and poor lifestyle choices.
生活在加拿大的南亚人群中糖尿病患病率较高，且代代相传，通常与个体风险因素相关，同时忽视了健康的社会决定因素（SDOH）。关于有2型糖尿病（T2DM）家族史的南亚青少年观点的研究较少。直接从这些青少年那里了解情况，可以通过洞察健康的社会决定因素如何导致南亚移民社区中T2DM的比例过高，来填补一个重大空白。
在本研究中，我们使用了摄影声音法，这是一种基于社区的参与性研究（CBPR）方法，涉及使用摄影从有实际经历者的角度直观地捕捉糖尿病预防的挑战。从安大略省皮尔地区的一个青少年糖尿病教育项目中招募了15名南亚青年。这些青年在焦点小组中讨论了他们的照片以及附带的书面叙述。
对照片和参与者叙述的主题分析得出了影响南亚社区T2DM表现的四个主题：1）移民和重新安置压力源；2）粮食不安全；3）不健康的学校环境；4）学业压力。
研究结果表明，需要将T2DM视为对不公正状况和环境的一种反应来加以应对，而不是将其视为一种由遗传易感性、文化和不良生活方式选择所导致的流行病。
