| 1. Financial insecurity |
Finance: ‘Yes. I mean, well what you are saying is if the person has a healthy mind. Now, he's unhealthy not because only of his not walking or walking. He's unhealthy also because he's occupied with something else, all the time. If like finances, worried about their finances, and things like that. The last thing they're going to be thinking about is their health. Going to be like ”I need to get these bills paid“. You know? So, I think their personal situations matter a lot, as well. And how they, you know, they deal with their lifestyle.‘ (FG3 GP) |
| 2. Cultural norms about food and eating |
‘You know, will you — like changing the food, and things like that — they [the family] probably wouldn't like that. Like, “Why are you making it healthier, why are you changing our cooking method, we don't want it like it that”.' (FG3 Manager)“The other thing for me is oil in curries — I remember a patient who I was always telling to eat fish, and they brought me a little bowl full of oil, but a little piece of fish sitting in the oil. And so I try and say ”How much oil do you buy in a month?” And it's like five litres or something.’ (FG1 GP) |
| 3. Gender roles and expectations |
‘The expectations of sometimes what men and women do. So, sometimes we think that you wouldn't get anywhere with men, but actually they're the ones who have the [um] permission within society to go to the gym, to be out, and not to have to do the housework and the childcare. [um] And for women, especially sort of women in their forties and fifties, that there's an expectation that you know, there is no social life, there's no [um] going out, you know, to go to an exercise class, and they're more at home. [um] And, and/or you need to ask permission to go out. And it's still — it surprises me that there's still quite a lot of that around. (FG 2 GP) |
| 4. Obesogenic environment |
‘FG1 GP: Just a walk round. You can see, you see all the chicken and chip shops. Fast food. Cheap and cheerful. So. Keep you happy for that moment, but after that, it depletes you, really. Drains you all the time.
Interviewer: So do you think it's that there's not enough healthy options, or they're too expensive?
FG1 GP: Yeah.
Interviewer: Not enough?
FG1 GP: There's not enough. Not enough [healthy food options]. And probably because it's too expensive.’
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| 5. Health literacy |
‘I guess sometimes the actual underlying knowledge about healthy eating isn't always there, as well. [um] Especially when you're dealing with someone who comes from a — is relatively isolated, who hasn't necessarily had the best schooling, is relatively new to the country. Changing everything round like eating, your entire life — you need to change everything, you need to eat what's on the NHS website — it's sometimes difficult to make that leap.’ (FG1 GP) |