Learning from listening: common concerns and perceptions about diabetes prevention among diverse American populations

Recent research findings confirming the feasibility and effectiveness of interventions to prevent or delay the onset of type 2 diabetes are of keen interest to many stakeholders, including communities from which diabetes exacts a heavy toll. To inform communication and program planners at national and local levels, the Division of Diabetes Translation, Centers for Disease Control and Prevention, turned to people and communities affected by diabetes for their views about diabetes prevention. We review the key themes that emerged across diverse populations and some examples of subthemes relevant to particular groups. Adults at risk for type 2 diabetes and community leaders from five racial and ethnic groups participated in 27 focus groups from five geographic locations across the country. We explored participants' knowledge, attitudes, and beliefs about diabetes and factors that would enable or impede lifestyle interventions at individual and community levels. Multiple analysts categorized responses using the qualitative technique of constant comparison. Many themes, some cutting across groups and some unique to specific groups, emerged about the negative effect of modern lifestyles on the health of adults and children. But positive findings about diabetes prevention generated hope that diabetes was not inevitable. All the focus groups noted that interventions were difficult to initiate and maintain and that social support, modeling stories, and community connections were needed. Listening to community members identified common and group-specific themes. These findings can inform health promotion messages and support adaptive community interventions for diabetes prevention.