Abstract
Aims
With numerous and continuing attempts at adapting diabetes self-management support programmes to better account for underserved populations, it’s important that the lessons being learned are understood and shared. The work we present here reviews the latest evidence and best practice in designing and embedding culturally and socially sensitive, self-management support programmes.
Methods
We explored the literature with regard to four key design considerations of diabetes self-management support programmes: Composition - the design and content of written materials and digital tools and interfaces; Structure - the combination of individual and group sessions, their frequency, and the overall duration of programmes; Facilitators - the combination of individuals used to deliver the programme; and Context – the influence and mitigation of a range of individual, socio-cultural, and environmental factors.
Results
We found useful and recent examples of design innovation within a variety of countries and models of health care delivery including Brazil, Mexico, Netherlands, Spain, United Kingdom, and United States of America. Within Composition we confirmed the importance of retaining best practice in creating readily understood written information and intuitive digital interfaces; Structure the need to offer group, individual, and remote learning options in programmes of flexible duration and frequency; Facilitators where the benefits of using culturally concordant peers and community-based providers were described; and finally in Context the need to integrate self-management support programmes within existing health systems, and tailor their various constituent elements according to the language, resources, and beliefs of individuals and their communities.
Conclusions
A number of design principles across the four design considerations were identified that together offer a promising means of creating the next generation of self-management support programme more readily accessible for underserved communities. Ultimately, we recommend that the precise configuration should be co-produced by all relevant service and patient stakeholders and its delivery embedded in local health systems.
With numerous and continuing attempts at adapting diabetes self-management support programmes to better account for underserved populations, it’s important that the lessons being learned are understood and shared. The work we present here reviews the latest evidence and best practice in designing and embedding culturally and socially sensitive, self-management support programmes.
Methods
We explored the literature with regard to four key design considerations of diabetes self-management support programmes: Composition - the design and content of written materials and digital tools and interfaces; Structure - the combination of individual and group sessions, their frequency, and the overall duration of programmes; Facilitators - the combination of individuals used to deliver the programme; and Context – the influence and mitigation of a range of individual, socio-cultural, and environmental factors.
Results
We found useful and recent examples of design innovation within a variety of countries and models of health care delivery including Brazil, Mexico, Netherlands, Spain, United Kingdom, and United States of America. Within Composition we confirmed the importance of retaining best practice in creating readily understood written information and intuitive digital interfaces; Structure the need to offer group, individual, and remote learning options in programmes of flexible duration and frequency; Facilitators where the benefits of using culturally concordant peers and community-based providers were described; and finally in Context the need to integrate self-management support programmes within existing health systems, and tailor their various constituent elements according to the language, resources, and beliefs of individuals and their communities.
Conclusions
A number of design principles across the four design considerations were identified that together offer a promising means of creating the next generation of self-management support programme more readily accessible for underserved communities. Ultimately, we recommend that the precise configuration should be co-produced by all relevant service and patient stakeholders and its delivery embedded in local health systems.
| Original language | English |
|---|---|
| Article number | 188 |
| Journal | International Journal for Equity in Health |
| Volume | 22 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 11 Sept 2023 |
Bibliographical note
Funding Information:Sabi Redwood’s and Theresa Moore’s time is supported by the National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West).
Funding Information:
Kerry Leeson-Beevers, Sarah Tearne, Charlotte Austin, Natalie Rowland (on behalf of the “Diversity in Diabetes” consortium*). *Diversity in Diabetes consortium members: C Austin ([email protected]), London; T Barrett ([email protected]), Birmingham;; F Campbell ([email protected]), Leeds; M Ford-Adams ([email protected]), London; S Greenfield ([email protected]), Birmingham; N Rowland ([email protected]), Birmingham; R Kandiyali ([email protected]), Warwick; K Khunti ([email protected]), Leicester; K Leeson-Beevers ([email protected]), Halifax; I Litchfield ([email protected]), Birmingham; T Moore ([email protected]), Bristol; P Narendran ([email protected]), Birmingham; V Puthi ([email protected]), Peterborough; S Redwood ([email protected]), Bristol; P Sachdev ([email protected]), Nottingham; A Searle ([email protected]), Bristol; J Shield ([email protected], Bristol; P Sundaram ([email protected]), Leicester; S Tearne ([email protected]), Birmingham; S Uday ([email protected]), Birmingham; J Wheeler ([email protected]), Bristol; R Willemsen ([email protected]), London.
Funding Information:
This project is funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research (PGfAR) Programme (Grant Reference Number NIHR202358. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2023, BioMed Central Ltd., part of Springer Nature.
