JMIR Publications

ABSTRACT

Background:

Immigrants to Canada belonging to ethnocultural minority groups are at increased risk of developing diabetes and complications, including diabetic retinopathy. They are also less likely to be screened and treated for diabetic retinopathy. Improved attendance to retinopathy screening (eye tests) has the potential to reduce permanent complications, including blindness.

Objective:

We aim to identify the barriers and enablers of attending diabetic retinopathy screening among ethnocultural minority immigrants living with diabetes in Quebec and Ontario (Canada) to inform the development of a behaviour change intervention to improve diabetic retinopathy screening attendance.

Methods:

The research question draws on the needs of patients and clinicians. Using an integrated knowledge translation approach the research team includes clinicians, researchers and patient partners who will contribute throughout the study, including developing and reviewing materials and procedures, helping to recruit and disseminating findings. Using a convenience snowball strategy, we will recruit participants from three target groups: South Asian, Chinese and French-speaking persons of African descent. To better facilitate reaching these groups and support participant recruitment, we will partner with community organizations and clinics serving our target populations in Ontario and Quebec. Data will be collected using semi-structured interviews using topic guides developed in English and translated into French, Mandarin, Hindi and Urdu and conducted in those languages. Data collection and analysis will be structured according to the Theoretical Domains Framework (TDF), which synthesizes predominant theories of behaviour change into 14 domains covering key modifiable factors that may operate as barriers or enablers to attending eye screening. We will use directed content analysis to code barriers and enablers to TDF domains, then thematic analysis to define key themes within domains.

Results:

Barriers and facilitators to diabetes retinopathy screening will be identified and understood in their cultural contexts.

Conclusions:

Findings from this study will inform the co-development of theory-informed, culturally- and linguistically-tailored interventions to support patients in attending retinopathy screening.