This paper from 1998, published in Diabetic Medicine, http://dx.doi.org/10.1002/(SICI)1096-9136(1998110)15:11%3C958::AID-DIA687%3E3.0.CO;2-9 Authors Simmons, Weblemoe, Voyle, Prichard, Leakehe and Gatland. The abstract is "The aim of this study was to identify and quantify barriers to diabetes care perceived by diabetic subjects from a multiethnic, urban community (mainly New Zealand Europeans, Maori, and Pacific Islanders). A qualitative survey including 57 diabetic subjects and health care providers from a diverse range of backgrounds was followed by a cross-sectional household survey. Barriers to care were quantified among 1862 (2.1 %) diabetic residents of a total surveyed population of 90 477. Thirty barriers to care categories were generated incorporating patient beliefs, internal and external physical barriers, educational, psycho-social and psychological barriers. In spite of major difference in culture, acculturation, and socio-economic status, the top 10 barriers were similar between the ethnic groups. The most important barriers were perceiving that the benefits of self-care were outweighed by the disadvantages (20 % Europeans, 20 % Maori, 29 % Pacific Islanders, 16 % others, p < 0.001), lack of community-based services (13 % Europeans, 27 % Maori, 25 % Pacific Islanders, 11 % others, p < 0.001) and the limited range of services available (15 % Europeans, 22 % Maori, 20 % Pacific Islanders, 14 % others, p < 0.05). It is postulated that definition of these barriers, with subsequent, systematic action to reduce their impact, in both patients and populations could result in an improvement in diabetes outcomes. © 1998 John Wiley & Sons, Ltd." https://www.researchgate.net/publication/13458608_Personal_barriers_to_diabetes_care_Lessons_from_a_multi-ethnic_community_in_New_Zealand
