"Those risks, that preventative work, that is the bedrock of family medicine": A foucauldian discourse analysis of communicating risk for type 2 diabetes among primary care providers.

Wendy M Blunt, Jennifer D Irwin, Robert J Petrella, Jacob Shelley, Maxwell J Smith

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Article in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Wendy M BluntFaculty of Health Sciences, School of Health Studies, Western University, 1151 Richmond Street, London, ON, N6A 5B9, Canada. wblunt@uwo.ca.

Jennifer D IrwinFaculty of Health Sciences, School of Health Studies, Western University, 1151 Richmond Street, London, ON, N6A 5B9, Canada.

Robert J PetrellaCentre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, N6G 2M1, Canada.

Jacob ShelleyFaculty of Health Sciences, School of Health Studies, Western University, 1151 Richmond Street, London, ON, N6A 5B9, Canada.

Maxwell J SmithFaculty of Health Sciences, School of Health Studies, Western University, 1151 Richmond Street, London, ON, N6A 5B9, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

With estimates suggesting 350 million individuals are at-risk for type 2 diabetes (T2D), there is an urgent need to critically understand the processes of risk communication with primary care providers. Prior research has shown that primary care is the most likely place where initial conversations with a patients about T2D risk occur, but there remains a paucity of research exploring what may govern this communication. The purpose of this study was to critically explore discourses of risk for preventing T2D from the perspective of primary care providers. Semi-structured interviews (n = 14) were conducted with primary care providers including family physicians (n = 4), medical residents (n = 2), nurses (n = 3), dietitians (n = 4), and a pharmacist (n = 1) working in family health team (FHT) clinics in Southwestern, Ontario, Canada. Foucauldian Discourse Analysis through thematic analysis was applied to analyze the data and generate themes detailing how provider communications about risk for T2D are governed through discourse. Themes included: (1) patient-centred practice; (2) diagnosing prediabetes; (3) contextualizing symptoms; (4) time contingent; (5) adapting to patient knowledge; (6) carefully discussing weight; and (7) age as a balancing act. Overall, providers note using discourses of patient-centred practice to guide approaches to communicating about risk for T2D to patients. There are tensions with fulfilling this ideal patient-centred approach from more powerful discourses of prediabetes, assumptions about patient knowledge, and age that may override the ability to be patient-centred with communications about risk for T2D.

Indexed as

CommunicationDiabetes Mellitus, Type 2Family PracticePrimary Health CareAdultAttitude of Health PersonnelFemaleHumansInterviews as TopicMaleOntarioPatient-Centered CarePrediabetic StateQualitative ResearchRisk FactorsFoucauldian discourse analysisHealth promotionPrediabetesPrimary careRisk communicationType 2 diabetes

Identifiers

PMID40640742

DOI10.1186/s12875-025-02899-7

PMCPMC12243163

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LicenceCC BY-NC-ND

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.