Obesity and associated chronic diseases, such as type 2 diabetes, are highly prevalent in the United Arab Emirates (UAE). This qualitative study explored weight management behaviours and perceptions of women who are at increased risk for type 2 diabetes through focus group interviews. A total of 75 Emirati national women (age, 20-60 years) considered high risk for type 2 diabetes participated in eight focus groups. Purposive sampling was used to recruit women from primary healthcare centres (PHCs) in Al Ain, UAE. Qualitative research methodology involving a modified approach to grounded theory was used to guide data collection and analysis. Focus group interviews transcripts were thematically analyzed using NVivo software. A number of personal, social and physical environmental themes emerged as both barriers and enablers that are consistent with the social ecological model of health promotion. Low motivation, lack of social support, competing demands, lack of culturally-sensitive exercise facilities and sociocultural norms that restrict outdoor physical activities were the main barriers cited by the participants. On the other hand, social support, such as having other women to walk with, helped them stay physically active. Suggestions from the participants included enhancing social support for women, greater access to dietitians and nutrition information, and increasing availability of culturally-sensitive exercise facilities. This study provides valuable information in the development of culturally congruent healthy weight promotion programmes for women at risk for type 2 diabetes in the UAE and has implications for obesity intervention programmes for women in other Arabian Gulf countries.

Obesity and associated chronic diseases such as type 2 diabetes are highly prevalent in the United Arab Emirates. This qualitative study explored weight management barriers for Emirati women and strategies that can facilitate their weight management efforts. In-depth individual interviews were conducted with a purposive sample of 29 primary health care physicians, dietitians, and nurses in Al Ain and Abu Dhabi medical districts. A modified grounded theory was used to guide data collection and analysis. Interview notes were analyzed thematically and inductively using the NVivo software. The three main emerging themes were barriers, motivators, and suggestions. A number of personal, health care system-related, social and physical barriers to weight management were identified. Participants' suggestions to facilitate weight management for Emirati women included: health awareness programs, policies that support lifestyle changes, and provision of the necessary resources. They recommended peer support and culturally-acceptable programs that provide a holistic approach to obesity prevention and management. This study has useful applications in the development of community-based interventions for the prevention and management of overweight and obesity among women in the United Arab Emirates.

BackgroundOver the last 30 years the citizens of the United Arab Emirates have experienced major changes in life-style secondary to increased affluence. Currently, 1 in 5 adults have diabetes mellitus, but the associations (clustering) among risk factors, as well as the relevance of the concept of the metabolic syndrome, in this population is unknown.AimTo investigate the prevalence and associations among cardiovascular risk factors in this population, and explore to what extent associations can be explained by the metabolic syndrome according to ATP-III criteria.MethodA community based survey, of conventional risk factors for cardiovascular disease was conducted among 817 national residents of Al Ain city, UAE. These factors were fasting blood sugar, blood pressure, lipid profile, BMI, waist circumference, smoking, or CHD family history. Odds ratios between risks factors, both unadjusted and adjusted for age and sex as well as adjusted for age, sex, and metabolic syndrome were calculated.ResultsVarious risk factors were positively associated in this population; associations that are mostly unexplained by confounding by age and sex. For example, hypertension and diabetes were still strongly related (OR 2.5; 95% CI 1.7–3.7) after adjustment. An increased waist circumference showed similar relationship with hypertension (OR 2.3; 95% CI 1.5–3.5). Diabetes was related to an increased BMI (OR 1.5; 96% CI 1.0–2.3). Smoking was also associated with diabetes (OR 1.9, 95% CI 1.0–3.3).Further adjustment for metabolic syndrome reduced some associations but several remained.ConclusionIn this population risk-factors cluster, but associations do not appear to be explained by the presence/absence of the ATP-III metabolic syndrome. Associations provide valuable information in planning interventions for screening and management.

BackgroundThe cost effective provision of quality care for chronic diseases is a major challenge for health care systems. We describe a project to improve the care of patients with the highly prevalent disorders of diabetes and hypertension, conducted in one of the major cities of the United Arab Emirates.Settings and MethodsThe project, using the principles of quality assurance cycles, was conducted in 4 stages.The assessment stage consisted of a community survey and an audit of the health care system, with particular emphasis on chronic disease care. The information gleaned from this stage provided feedback to the staff of participating health centers. In the second stage, deficiencies in health care were identified and interventions were developed for improvements, including topics for continuing professional development.In the third stage, these strategies were piloted in a single health centre for one year and the outcomes evaluated. In the still ongoing fourth stage, the project was rolled out to all the health centers in the area, with continuing evaluation. The intervention consisted of changes to establish a structured care model based on the predicted needs of this group of patients utilizing dedicated chronic disease clinics inside the existing primary health care system. These clinics incorporated decision-making tools, including evidence-based guidelines, patient education and ongoing professional education.ResultsThe intervention was successfully implemented in all the health centers. The health care quality indicators that showed the greatest improvement were the documentation of patient history (e.g. smoking status and physical activity); improvement in recording physical signs (e.g. body mass index (BMI)); and an improvement in the requesting of appropriate investigations, such as HbA1c and microalbuminurea. There was also improvement in those parameters reflecting outcomes of care, which included HbA1c, blood pressure and lipid profiles. Indicators related to lifestyle changes, such as smoking cessation and BMI, failed to improve.ConclusionChronic disease care is a joint commitment by health care providers and patients. This combined approach proved successful in most areas of the project, but the area of patient self management requires further improvement.

This practice-based audit provides an essential assessment for future interventions to improve adherence to healthy life style behaviors among patients with diabetes and hypertension attending primary health clinics in the UAE.