Table 4: Study characteristics.

Lead author, year of publicationResearch questionParticipant sampleMethod of data collectionAnalytic strategies Themes from results

Choudhury et al.
2009 [18]
Examine the understanding and beliefs of people with diabetes in terms of their condition, its causes, prevention, and management n = 14
4 male, 10 female, aged 26–67 yrs: Bangladeshi
All with type 2 diabetes
Structured interviewsData transcribed and analysed, coded by two independent researchers using word and excel following the preset questions(i) Cause of diabetes
(ii) Preventing diabetes
(iii) Diabetes diagnosis
(iv) Management of diabetes
(v) Information from healthcare professionals
(vi) Physical activity
(vii) Information from family/friends and use of traditional medication
(viii) Diabetes education

Darr et al. 2008 [19]To compare illness beliefs of South Asian and European patients with CHD about causal attributions and lifestyle change
n = 65
Pakistani and Indian: 26 males, 19 females, aged 40–82 European: 10 males, 10 females, aged 42–83
All with CHD
InterviewsFramework approach analysis [20]Causal attributions and lifestyle change
(i) Family history
(ii) The role of fate
(iii) Stress
(iv) Tobacco smoking
(v) Physical activity and exercise
(vi) Dietary intake
(vii) Stress management

Farooqi et al.
2000 [21]
To identify key issues relating to knowledge of and attitudes to lifestyle risk factors for CHDn = 44
24 male, 20 female
South Asians aged 40+ yrs
Focus groupsThematic/content analysis(i) Diet
(ii) Exercise
(iii) Smoking
(iv) Alcohol
(v) Accessibility of health services
(vi) Stress

Grace et al. 2008 [22]To understand lay beliefs and attitudes, religious teachings, and professional perceptions in relation to diabetes prevention n = 137
54 males, 83 females;
80 Bangladeshi lay people (37 females, 43 males, mean age 35), 29 Islamic religious leaders, 28 health professionals
Focus groups, 3 sequential phases (vignettes)Thematic analysis with use of NVIVO, multilevel theoretical framework, and critical fiction technique(i) Lay understanding of diabetes
(ii) Living a “healthy” life
(iii) Responsibility for diabetes prevention
(iv) Fatalism
(v) Social roles and expectations
(vi) Structural and practical constraints to healthy lifestyle choices
(vii) Health literacy and English fluency

Greenhalgh et al. 1998 [23]To explore the experiences of diabetes and underlying attitudes and belief systems which drive that behaviourn = 50
40 Bangladeshi (17 males, 23 females), 8 white British, 2 Afro-Caribbean aged 21–80
All with diabetes not distinguish which type
Semistructured interviewsAnalysed using NUDIST software(i) Body concepts
(ii) Origin and nature of diabetes
(iii) Impact of diabetes
(iv) Diet and nutrition
(v) Smoking
(vi) Concepts of balance
(vii) Exercise
(viii) Professional roles
(ix) Diabetic monitoring

Lawton et al. 2008
[24]
To look at food and eating practices from the perspectives
of those with type 2 diabetes, barriers and facilitators to dietary change, and social and cultural factors informing their accounts
n = 32
15 male, 17 female; aged 33–71, Pakistani and Indian
All with type 2 diabetes
Topic-guided interviewConstant comparative method of analysis [10] in line with Grounded theory approach. QSR*NUDIST used(i) Information from healthcare professionals
(ii) Perceptions of SA foods: bad for health; good for self
(iii) Settlement, sharing, and commensality
(iv) Strategies for passing: cutting out or cutting down

Choudhury et al.
2009 [18]
Patients’ perceptions and experiences of undertaking physical activity as part of their diabetes caren = 32
15 male, 17 female; Pakistani and Indian patients aged 33–71
All with type 2 diabetes
Interviews informed by a topic guideConstant comparative method of analysis [10] in line with Grounded theory approach. QSR*NUDIST usedRoles, norms, and responsibilities:
(i) Lack of time: obligations to others
(ii) Fear and shame
External constraints:
(i) Lack of culturally sensitive facilities
(ii) Climatic conditions
Perceptions and experiences of disease:
(i) Comorbidities
(ii) Accounts of causation; perceptions of future health
(iii) Diabetes triggers irreversible decline
(iv) Physical activity can engender anxiety
Activities and active respondents:
(i) Short-term goals

Ludwig et al. 2011
[25]
Explored health perceptions, diet and the social construction of obesity and how this relates to the initiation and maintenance of a healthier diet in UK Pakistani womenn = 55
Pakistani women aged 23–80
Semistructured interviews use of fictional vignettes
and body shape images
Analysis using phenomenological and sociological approachesPhenomenological analysis:
(i) Diabetes symptoms
(ii) Reasons for overweight
(iii) Health action
(iv) Motivation to change
Sociological analysis:
(i) Identity deconstruction: Muslim, Pakistani, and British
(ii) Family
Emergent themes:
(i) Risk awareness
(ii) Urban versus Rural background
(iii) Climate
(iv) Food traditions/expectations
(v) English versus Pakistani food
(vi) Obesity and health

Sriskantharajah and Kai 2007 [26]To explore the influences on, and attitudes towards, physical activity among South Asian women with CHD and diabetes to inform secondary prevention strategiesn = 15
(all female, aged 26–70)
South Asian
All with either CHD and/or noninsulin-dependent diabetes
Semistructured interviewsTranscribed and analysis informed by Grounded theory(i) Perceived harm threshold limits activity
(ii) Insufficient guidance from health professionals
(iii) Weight loss, maintaining independence, and socialising perceived as main benefits of exercising
(iv) Some understanding of benefit of exercise
(v) Exercise beyond daily work seen as “selfish” activity
(vi) Discomfort with exercising in public
(vii) Constrained by not being able to speak English

Stone et al. 2005 [27]To explore the experience and attitudes of primary care patients with diabetes living in a UK community with particular reference to South Asians and patient empowermentn = 20
(9 males, 11 females; aged 33–80; 15 South Asians, 5 Caucasian)
South Asians
All with diabetes
Semistructured interviewsTranscribed and emerging themes informed subsequent interviews, use of Thematic analysis using Framework charting(i) The patient experience: attitudes to diagnosis
(ii) The patient experience: difficulties faced
(iii) Types of support: emotional support
(iv) Types of support: empowerment through knowledge
(v) Attitudes to self-management
(vi) Barriers to knowledge acquisition