Table 1.

Themes identified by community stakeholders regarding diabetes among Hispanics

Importance of diabetes as a public health problem
➢ Highly prevalent among Hispanics	“We don’t know a single family who doesn’t have one or two people in their family with diabetes.” (ID 10083).
➢ Diabetes is diagnosed in late stages (never early) once the symptoms appear	“…sometimes people can be walking around with diabetes for five, six, seven years. And then they come in here because all of a sudden they passed out…’cause diabetes catches up with you if you don’t catch it if you don’t know you have it…” (ID 10081)
➢ Diabetes being diagnosed on a consistent basis, younger and younger	“…it seems like on a consistent basis diagnosing diabetics all the time, and it seems like they’re getting younger and younger…” (ID 10118)
➢ Risk increases with increasing time living in the United States	“…I just read an article…and their [Hispanics’] percent of getting it five years after being residents in this country it’s very high, it’s like 18% increased…” (ID 10079)
Individual barriers to diagnosis and/or treatment
➢ Lack of knowledge or information	“…a lot of our Hispanic folks do not have education regarding diabetes, how to take care of it, what the symptoms are, what to do…” (ID 10081)
➢ Lack of access to information or services	“I think there’s information available, but whether they have access to know about the information is another thing I don’t think, I don’t see a great concentration or an effort being made up to this point of informing people.” (ID 10086)
➢ Financial barriers	“There’s financial barriers to doing that if you have to be on the job, you can’t leave the job to go get the education, spend the time in the doctor’s office and the expense of making payments on that medical care…” (ID 10077)
➢ Lack of personal responsibility	“…it’s traumatic, you have to test yourself, you have to eat three or four times a day, you have to make sure you eat something for every two hours…I mean your whole lifestyle changes. And that’s hard to accept. It was for me always. I fought it. I still fight it.” (ID 10080)
Structural barriers to diagnosis and/or treatment
➢ Community informational events on diabetes are insufficiently advertised	“…things that you hear on public radio KDNA for example, you’ll hear a program every once in awhile, Farmworkers, you’ll hear them having health fairs every once in awhile, though I don’t think they do a very good job of getting it out to the general population.”(ID 10118)
➢ Information and events offered by community organizations or hospitals are not often in Spanish and/or are not culturally or educationally appropriate	“…sometime…brochures…are only in English, they’re not in Spanish, and then sometimes the language in them is way over our heads…a lot of our families…their education is very low…” (ID 10082)
➢ Exercise programs are missing	“No, no there isn’t (any class about exercise). They are necessary, they are necessary.” (ID 10119)
➢ Spanish radio stations offer little to no information on diabetes	“Their use of the media is mainly television and radio and I don’t think major portion listen to types of stations that would advertise or have commercials… regarding this diabetes…” (ID 10086)
➢ No independent presence of American Diabetes Association in the community – only serve as a contact for physicians	“I’ve not heard of it. To be honest with you. I always think about the diabetes association and I see ads on TV about it, so but they need to centralize, something needs to be centralized, where people can go to. I dream of that.”(ID 10081)
➢ Not enough is done in schools to inform students and parents about diabetes	“My 12 year old is going through health class and they’re talking about different aspects of health, nutrition being one of them but yet, in the hallways they have soda machines, in the lunch line they have the brownies…so I think the dieticians for the school districts need to change their attitude.” (ID 10118)