Barriers and facilitators to accessing preventive services for chronic diseases among people from South Asian backgrounds living in Sydney

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Abstract

Background People from South Asian backgrounds, including those of Bangladeshi and Nepalese origin, have a disproportionate burden of chronic diseases, i.e., diabetes and cardiovascular diseases. While preventive services are essential, these population groups demonstrated limited access to existing preventive services in Australia. The present study explored the barriers and facilitators to accessing preventive care services among people from Bangladeshi and Nepalese origins living in Sydney, Australia. Methods This qualitative study was conducted following the constructivist paradigm, where realities are constructed on the lived experiences of the participants. Six focus group discussions (FGDs) and 22 in-depth interviews (IDIs) were conducted during August 2024 and January 2025 with people of Bangladeshi and Nepalese origin living in Sydney. FGDs and IDIs were conducted in participants’ language, transcribed, translated into English, and thematically analysed. The barriers and facilitators at different levels were structured following the socio-ecological framework. Results Several barriers and facilitators were identified across different levels of the socioecological framework. Individual-level barriers included cultural and religious perceptions, limited health literacy, and a lack of awareness of preventive services. Interpersonal barriers included limited English language skills, a lack of translated health education materials and interpreter services and limited cultural understanding among health service providers. Community-level barriers involved chronic disease-related stigma and lack of community engagement. Institutional and policy barriers included limited culturally tailored support and infrequent public transport to health facilities. Conversely, facilitators included self-awareness and ownership of health, knowledge about available preventive services, peer support, cultural and linguistic competency of health care providers, use of digital and social media for health information sharing, and the role of community organisations. Conclusion These findings suggest implementing multi-level, culturally tailored, community-led interventions leveraging community and social engagement platforms to ensure adequate access to available preventive services for chronic diseases among these disadvantaged population groups in Australia.

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