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Purpose. The majority of people with type 2 diabetes do not meet dietary and physical activity recommendations. It is not well understood how diabetes educators translate diet and physical guidelines for their clients and if diabetes educators have sufficient resources to promote healthy eating and physical activity. This research addressed these questions through exploratory qualitative interviews. Method. A total of 13 diabetes educators who work in Alberta, Canada, were interviewed. Results. The reasons for lack of client uptake of lifestyle recommendations were complex and interwoven. The strongest theme to emerge was the clients’ prior knowledge and skills affecting their ability to uptake knowledge. However, educators recognized that clients are affected by social, environmental, cultural, and personal factors. Conclusions. Health system and societal issues cause a cascade effect resulting in difficulties for both educators and clients. To achieve appropriate treatment of type 2 diabetes, changes need to occur at a health systems level. [ABSTRACT FROM PUBLISHER]

Objective: To explore the barriers associated with the adoption of the Alberta Nutrition Guidelines for Children and Youth in schools according to characteristics of the innovation (guidelines) and the organization (schools). Design: Cross-sectional telephone survey. Setting and Participants: Schools in Alberta, Canada. Principals from 357 schools. Main Outcome Measure: Barriers to adopting the nutrition guidelines. Analysis: A 19-question telephone survey, including open- and closed-ended questions, was used to obtain information regarding schools' characteristics and barriers to adopting the guidelines. Qualitative data were coded according to common themes a priori, based on constructs from the Diffusion of Innovations framework. Results: Schools reported many barriers related to the relative advantage, compatibility, and complexity of adopting the guidelines. Parents' resistance to change and cost were the key reported barriers. Lack of knowledge, student preferences, the physical location of the school, and barriers related to the provision of healthful food were also reported. Conclusions and Implications: Disseminating guidelines without providing adequate support for their implementation may not promote change within the school setting. School nutrition initiatives need to involve the parents and have access to sufficient financial and human resource support. [ABSTRACT FROM AUTHOR]