{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T14:28:11Z","timestamp":1754144891110,"version":"3.41.2"},"reference-count":55,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Prom J of Aust"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Issue Addressed<\/jats:title><jats:p>Footcare is an integral part of diabetes self\u2010management, yet there is limited research on diabetes footcare self\u2010management. This paper explores footcare self\u2010management and the impact of diabetes foot complications amongst I\u2010Taukei Fijians in Fiji.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This mixed\u2010method research examines data from the innovative Fijian Diabetes Cam study, consisting of photographic images, photo\u2010elicitation interviews, and researcher observation. A strategic sample of 30 I\u2010Taukei Fijian adults with diabetes participated. Participants wore a camera that photographed their activities, behaviour, and environment every 7\u2009s for 4\u2009days. Images were used in semi\u2010structured photo\u2010elicitation interviews at home, with the images as prompts. Image data and observation were descriptively analysed, while photo\u2010elicitation responses were thematically analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>While all participants said they performed footcare, for most this was limited to looking for cuts and wounds. Those with foot complications such as amputations have to leave employment. Facilitators included family and community support. Key barriers included the lack of preventive health services and support; poor resourcing and accessibility of dressing supplies, blood sugar testing kits and mobility aids and the warm climate hindering the wearing of closed shoes. Access to appropriate housing and transportation were also key barriers for those with amputations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study suggests that I\u2010Taukei patients recognise the need for footcare self\u2010management and are largely motivated to do it. However, there is a lack of health education and the health service lacks the resources and trained staff to meet the needs of the people. The underfunded and under\u2010resourced health system is a major contributor. Nevertheless, there are opportunities to improve health promotion actions.<\/jats:p><\/jats:sec><jats:sec><jats:title>So What?<\/jats:title><jats:p>Health promotion approach to diabetes footcare self\u2010management in Fiji could significantly improve the lives of people living with diabetes and reduce the risk of complications and amputation. Donor countries and WHO need to consider the support provided to assist Fiji to manage this increasingly challenging public health issue.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hpja.70076","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T03:25:23Z","timestamp":1752204323000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u2018Diabetes Makes You Lose Your Leg\u2019: Footcare Self\u2010Management Amongst I\u2010Taukei Fijians\u2014A Wearable Camera Study"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9175-7386","authenticated-orcid":false,"given":"Keresi Rokorua","family":"Bako","sequence":"first","affiliation":[{"name":"Health Promotion &amp; Policy Research Unit, Department of Public Health University of Otago  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5048-9719","authenticated-orcid":false,"given":"Masoud","family":"Mohammadnezhad","sequence":"additional","affiliation":[{"name":"Faculty of Health, Education and Life Sciences Birmingham City University  Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dianne","family":"Sika\u2010Paotonu","sequence":"additional","affiliation":[{"name":"Dean's Department Wellington, Division of Health Sciences University of Otago  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"D'Souza","sequence":"additional","affiliation":[{"name":"Health Promotion &amp; Policy Research Unit, Department of Public Health University of Otago  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4715-6718","authenticated-orcid":false,"given":"Louise","family":"Signal","sequence":"additional","affiliation":[{"name":"Health Promotion &amp; Policy Research Unit, Department of Public Health University of Otago  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1016\/S0140-6736(23)01296-5","article-title":"Diabetes: A Defining Disease of the 21st Century","volume":"401","year":"2023","journal-title":"Lancet"},{"unstructured":"World Health Organization \u201cDiabetes \u201daccessed April 5 2023 https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/diabetes.","key":"e_1_2_13_3_1"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.diabres.2021.109119","article-title":"International Diabetes Federation Diabetes Atlas: Global, Regional and Country\u2010Level Diabetes Prevalence Estimates for 2021 and Projections for 2045","volume":"183","author":"Sun H.","year":"2022","journal-title":"Diabetes Research and Clinical Practice"},{"key":"e_1_2_13_5_1","first-page":"26","volume-title":"Diabetes Remains a Significant Health Challenge in the Pacific","author":"Tukuitonga C.","year":"2016"},{"unstructured":"International Diabetes Federation (IDF) \u201cDiabetes in Western Pacific 2021 \u201dhttps:\/\/diabetesatlas.org\/idfawp\/resource\u2010files\/2021\/11\/IDF\u2010Atlas\u2010Factsheet\u20102021_WP.pdf.","key":"e_1_2_13_6_1"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.jcot.2021.01.017","article-title":"The Current Burden of Diabetic Foot Disease","volume":"17","author":"Edmonds M.","year":"2021","journal-title":"Journal of Clinical Orthopaedics and Trauma"},{"issue":"11","key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1111\/dme.13054","article-title":"Association of Diabetic Foot Ulcer and Death in a Population\u2010Based Cohort From the United Kingdom","volume":"33","author":"Walsh J. 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