VDPA - Vancouver Diabetes Priorities Assessment Study


Overview


Type 2 diabetes is a major health challenge worldwide, with urbanization fueling its rise in many cities. There is already much knowledge about the impact of biomedical and socio-economic factors on diabetes and its outcomes, but cultural and wider social effects have yet to be looked at in more detail. By examining diabetes within urban lifestyles, we can identify at-risk populations and customize public health efforts in ways that are relevant to these settings. Given the complexity of the issue, this study will use a multidisciplinary approach to look at social and cultural factors of diabetes specific to the Greater Vancouver setting.

The Vancouver Diabetes Priorities Assessment (VDPA) Study will use an online tool and qualitative analysis to explore priorities and attitudes around diabetes, health and well-being, and it will guide public health efforts based on findings. Using insights provided by Greater Vancouverites living with type 2 diabetes, it will be able to identify and prioritize social factors and cultural determinants that impact citizens’ capabilities, decisions and behaviours around diabetes. The VDPA Study will communicate its findings to local stakeholders and across the CCD network, including through social media outlets as well as through scientific dissemination and publication planning.

The VDPA Study is CoHeaRT’s first project since joining the CCD Global Partnership Programme. The study will be adapted for other CCD cities once this pilot project is complete.


Background


Vancouver is commonly thought of as a health-conscious city; however, according to a new analysis coordinated by CCD, almost 10% of the population are living with diabetes, one quarter of which are yet to be diagnosed1. Importantly, the prevalence of diabetes in Vancouver has been shown to differ greatly between neighbourhoods. Estimations show that incidence of the disease in the more affluent Westside of Vancouver is only 5.23%, whereas it is 7.84% in the Downtown Eastside and as high as 10.07% in South Vancouver. Ethnicity itself is a known risk factor for diabetes in Vancouver, as some of the most populous ethnic groups in the area – Chinese, South Asian and Aboriginal – have a disproportionate level of risk for diabetes compared to Europeans of the same body-mass index 2, 3.

Socioeconomic status, ethnicity and community environment intersect with many other complex factors to determine diabetes risk in Vancouver. The current project will help us learn about the relative importance of social and cultural factors of diabetes across the range of people living in Greater Vancouver in order to get a more rounded understanding of the disease, its causes and impacts.


Objectives


1. To validate the presence and explore the relative prioritization of pre-identified social factors and cultural determinants of diabetes among Greater Vancouverites with type 2 diabetes.

2. To answer the question of why these social factors and cultural determinants are important and how they shape health and diabetes in subgroups of Greater Vancouver residents.

3. To use the results to guide a targeted local research platform around reducing diabetes prevalence, and further strengthen the global Cities Changing Diabetes research platform around social factors and cultural determinants of type 2 diabetes.


Methodology


The Vancouver Diabetes Priorities Assessment (VDPA) utilises a 3-part research tool to explore the local social factors and cultural determinants of type 2 diabetes and their impact on people living with diabetes. This project will invite Greater Vancouverites living with type 2 diabetes to participate in an online survey, statement sorting activity and focus group to help understand the local relevancy of a series established sociocultural factors in diabetes.

The VDPA Study builds on CCD research in five partnering cities and is based on the principles of Q-methodology. Q-methodology utilizes a variant of statistical factor analysis to explore correlations between individuals based on their opinions and thoughts around a certain topic. In a Q-study, participants are correlated to each other and grouped together around a shared priorities, attitudes, and points of views by means of a statement sorting procedure (the Q-sort).

Through statistical analysis, participants who express a similar point of view in the statement sorting procedure are grouped together. Each group is then described based on the commonly held point of view and on the characteristics of the participants in the group. Available demographic data and participant comments collected during the focus groups aid interpretation of findings. Findings from both the Q-sort and the focus groups are then synthesized in a final analysis and a report is produced.


Progress to Date


Study recruitment began in late 2017 and is still open to participants living with type 2 diabetes in the Greater Vancouver area. Preliminary analyses will begin in summer 2018.


References


  1. InSource. (2016). Cities Changing Diabetes Rule of Halves Analysis - Vancouver.
  2. Lear, S. A., Chen, M. M., Frohlich, J. J., Birmingham, C. L. (2002). The relationship between waist circumference and metabolic risk factors: cohorts of European and Chinese descent. Metabolism, 51(11), 1427–1432.
  3. Razak, F., Anand, S., Vuksan, V., Davis, B., Jacobs, R., Teo, K. K., Yusuf, S. (2005). Ethnic differences in the relationships between obesity and glucose-metabolic abnormalities: a cross-sectional population-based study. International Journal of Obesity, 29(6), 656–667.