Immigrant Community Leaders Identify Four Dimensions of Trust for Culturally Appropriate Diabetes Education and Care

This paper explores immigrant community leaders’ perspectives on culturally appropriate diabetes education and care. We conducted exploratory workshops followed by focus groups with Punjabi, Nepali, Somali, and Latin American immigrant communities in Ottawa, Ontario. We used the constant comparative method of grounded theory to explore issues of trust and its impact on access and effectiveness of care. Detailed inquiry revealed the cross cutting theme of trust at the “entry” level and in relation to “accuracy” of diabetes information, as well as the influence of trust on personal “privacy” and on the “uptake” of recommendations. These four dimensions of trust stood out among immigrant community leaders: entry level, accuracy level, privacy level, and intervention level and were considered important attributes of culturally appropriate diabetes education and care. These dimensions of trust may promote trust at the patient-practitioner level and also may help build trust in the health care system.