Developing practice-led solutions for intergenerational diabetes in Pacific populations: a participatory action research project in general practice

INTRODUCTION: Addressing complex clinical and service delivery challenges in general practice, such as managing type 2 diabetes (T2D) in Pacific families experiencing intergenerational diabetes, is difficult. AIM: This study used participatory action research (PAR) to identify initial steps toward a new model of T2D care for Pacific peoples, to disrupt the cycle of intergenerational diabetes. METHODS: A modified PAR process was undertaken in a very low-cost access general practice serving a predominantly Pacific population. Six sequential focus groups (FGs) were held with clinical, support, and management staff. Each FG built on the previous one through iterative member checking, with analysis informing subsequent discussions. Framework analysis was used to synthesise data and identify areas for action. RESULTS: Twenty-one staff from a wide range of disciplines participated in six FGs. Staff identified challenges in current care and generated ideas for improving service delivery. Through iterative discussion, the team identified potential next steps, including a focus on Pacific people under 40 years of age with T2D, developing a wider range of literacy and communication tools, and exploring more empowering approaches to discussing diabetes. Staff also identified areas requiring support from the Primary Health Organisation, the community, and wider public health initiatives. DISCUSSION: PAR, informed by appreciative inquiry, provided a structured, collaborative process that supported staff to reflect on practice, consider alternative approaches, and clarify priorities for future development. Although the longer-term impact is not known, the process fostered engagement, strengthened the research-practice partnership, and generated feasible directions for enhancing care for Pacific families experiencing intergenerational diabetes.