Theory-informed strategies to address factors anticipated to influence implementation and people's participation in community pharmacy-based diabetes prevention services

Thando Katangwe-Chigamba*, Jeremy Sokhi, Hannah E Family, Hiyam Al-Jabr, Charlotte Kirkdale, Michael J. Twigg

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)

Abstract

Background
Early identification of non-diabetic hyperglycaemia and implementation of diet and lifestyle changes can prevent type 2 diabetes. However, low participation in diabetes prevention services remains a problem in the UK. The community pharmacy, one of the most accessible healthcare settings in the UK, could provide one solution to improving participation.

Aim
To prioritize factors that could influence delivery of, and people-participation in, community pharmacy-based diabetes prevention services, and to identify strategies to facilitate successful implementation.

Methods
A mixed-methods, primary care-based study, comprising of two stages: 1- Prioritising key influences of participation and delivery using a structured nominal group technique with people with non-diabetic hyperglycemia, and other stakeholders; 2 – Identifying theory informed strategies to facilitate successful implementation using framework analysis. This involved mapping prioritised influences and qualitative data from the nominal group technique onto the Behaviour Change Wheel theoretical framework. The study was conducted in February 2019, in Norfolk, UK and ethical approval obtained prior to research commencing.

Results
Fifteen participants (five people with non-diabetic hyperglycaemia, nine community pharmacy and general practice staff and one commissioner) participated. Participants prioritised “awareness” and “service integration” as key factors likely to influence participation and “the provision of information about health consequences e.g., leaflets” and “action planning e.g. general practice referral of patients to prevention services” as key strategies to facilitate participation. “Training”, “staffing levels” and “workload” were amongst the key factors prioritised as most likely to influence delivery. Strategies identified to facilitate implementation included “instructions of how to perform the behaviour e.g. standard operating procedures” and “reward e.g. funding”.

Conclusions
This research provides theoretical informed strategies needed to facilitate successful implementation of community pharmacy-based diabetes prevention services. The findings of this study should inform the design of future diabetes prevention services to ensure participation and sustainability.

Keywords
Community pharmacyBehaviour change wheelCOM-BBehaviour change techniquesDiabetes preventionType 2 diabetes
Abbreviations
COM-BCapability, Opportunity and Motivation for undertaking a BehaviourCPPECentre for Pharmacy Postgraduate EducationGPGeneral PracticeHCAsHealthcare AssistantsNDHNon-diabetic hyperglycaemiaNHSNational Health ServiceNHS DPPNational Health Service Diabetes Prevention ProgrammeT2DMType-2 Diabetes Mellitus
Original languageEnglish
Article number100263
JournalExploratory Research in Clinical and Social Pharmacy
Volume10
Early online date10 Apr 2023
DOIs
Publication statusE-pub ahead of print - 10 Apr 2023

Bibliographical note

Funding Information:
This work was conducted as part of Thando Katangwe-Chigamba's PhD which was funded by the University of East Anglia and Boots UK .

Publisher Copyright:
© 2023 The Authors

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