“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

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 conver...

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Main Authors: Wendy M. Blunt, Jennifer D. Irwin, Robert J. Petrella, Jacob Shelley, Maxwell J. Smith
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Primary Care
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Online Access:https://doi.org/10.1186/s12875-025-02899-7
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author Wendy M. Blunt
Jennifer D. Irwin
Robert J. Petrella
Jacob Shelley
Maxwell J. Smith
author_facet Wendy M. Blunt
Jennifer D. Irwin
Robert J. Petrella
Jacob Shelley
Maxwell J. Smith
author_sort Wendy M. Blunt
collection DOAJ
description 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.
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spelling doaj-art-95f4d6877bf34bcea2da00315949f95c2025-08-20T04:03:01ZengBMCBMC Primary Care2731-45532025-07-0126111410.1186/s12875-025-02899-7“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 providersWendy M. Blunt0Jennifer D. Irwin1Robert J. Petrella2Jacob Shelley3Maxwell J. Smith4Faculty of Health Sciences, School of Health Studies, Western UniversityFaculty of Health Sciences, School of Health Studies, Western UniversityCentre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western UniversityFaculty of Health Sciences, School of Health Studies, Western UniversityFaculty of Health Sciences, School of Health Studies, Western UniversityAbstract 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.https://doi.org/10.1186/s12875-025-02899-7Type 2 diabetesPrediabetesRisk communicationPrimary careHealth promotionFoucauldian discourse analysis
spellingShingle Wendy M. Blunt
Jennifer D. Irwin
Robert J. Petrella
Jacob Shelley
Maxwell J. Smith
“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
BMC Primary Care
Type 2 diabetes
Prediabetes
Risk communication
Primary care
Health promotion
Foucauldian discourse analysis
title “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
title_full “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
title_fullStr “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
title_full_unstemmed “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
title_short “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
title_sort 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
topic Type 2 diabetes
Prediabetes
Risk communication
Primary care
Health promotion
Foucauldian discourse analysis
url https://doi.org/10.1186/s12875-025-02899-7
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