Users’ experiences of a pragmatic diabetes prevention intervention implemented in primary care: qualitative study
Objectives To explore service-user and provider experience of the acceptability and value of the Let’s Prevent Diabetes programme, a pragmatic 6-hour behavioural intervention using structured group education, introduced into primary care practice.Design Qualitative interview-based study with themati...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/8/e028491.full |
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| author | Thomas Yates Joe Kai Navneet Aujla Helen Dallosso |
| author_facet | Thomas Yates Joe Kai Navneet Aujla Helen Dallosso |
| author_sort | Thomas Yates |
| collection | DOAJ |
| description | Objectives To explore service-user and provider experience of the acceptability and value of the Let’s Prevent Diabetes programme, a pragmatic 6-hour behavioural intervention using structured group education, introduced into primary care practice.Design Qualitative interview-based study with thematic analysis.Setting Primary care and community.Participants Purposeful sample of 32 participants, including 22 people at high risk of diabetes who either attended, defaulted from or declined the intervention; and 10 stakeholder professionals involved in implementation.Results Participants had low prior awareness of their elevated risk and were often surprised to be offered intervention. Attenders were commonly older, white, retired and motivated to promote their health; who found their session helpful, particularly for social interaction, raising dietary awareness, and convenience of community location. However attenders highlighted lack of depth, repetition within and length of session, difficulty meeting culturally diverse needs and no follow-up as negative features. Those who defaulted from, or who declined the intervention were notably apprehensive, uncertain or unconvinced about whether they were at risk of diabetes; sought more specific information about the intervention, and were deterred by its group nature and day-long duration, with competing work or family commitments. Local providers recognised inadequate communication of diabetes risk to patients. They highlighted significant challenges for implementation, including resource constraints, and facilitation at individual general practice or locality level.Conclusions This pragmatic diabetes prevention intervention was acceptable in practice, particularly for older, white, retired and health-motivated people. However, pre-intervention information and communication of diabetes risk should be improved to increase engagement and reduce potential fear or uncertainty, with closer integration of services, and more appropriate care pathways, to facilitate uptake and follow-up. Further development of this, or other interventions, is needed to enable wider, and more socially diverse, engagement of people at risk. Balancing a locality and individual practice approach, and how this is resourced are considerations for long-term sustainability. |
| format | Article |
| id | doaj-art-d2697f542f0442078396a2eeb9bf0fc7 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-d2697f542f0442078396a2eeb9bf0fc72024-11-27T01:45:09ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2018-028491Users’ experiences of a pragmatic diabetes prevention intervention implemented in primary care: qualitative studyThomas Yates0Joe Kai1Navneet Aujla2Helen Dallosso3Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UKDivision of Primary Care & National Institute for Health Research, School of Medicine, University of Nottingham, Nottingham, UK1 Warwick Medical School, University of Warwick, Coventry, UKLeicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UKObjectives To explore service-user and provider experience of the acceptability and value of the Let’s Prevent Diabetes programme, a pragmatic 6-hour behavioural intervention using structured group education, introduced into primary care practice.Design Qualitative interview-based study with thematic analysis.Setting Primary care and community.Participants Purposeful sample of 32 participants, including 22 people at high risk of diabetes who either attended, defaulted from or declined the intervention; and 10 stakeholder professionals involved in implementation.Results Participants had low prior awareness of their elevated risk and were often surprised to be offered intervention. Attenders were commonly older, white, retired and motivated to promote their health; who found their session helpful, particularly for social interaction, raising dietary awareness, and convenience of community location. However attenders highlighted lack of depth, repetition within and length of session, difficulty meeting culturally diverse needs and no follow-up as negative features. Those who defaulted from, or who declined the intervention were notably apprehensive, uncertain or unconvinced about whether they were at risk of diabetes; sought more specific information about the intervention, and were deterred by its group nature and day-long duration, with competing work or family commitments. Local providers recognised inadequate communication of diabetes risk to patients. They highlighted significant challenges for implementation, including resource constraints, and facilitation at individual general practice or locality level.Conclusions This pragmatic diabetes prevention intervention was acceptable in practice, particularly for older, white, retired and health-motivated people. However, pre-intervention information and communication of diabetes risk should be improved to increase engagement and reduce potential fear or uncertainty, with closer integration of services, and more appropriate care pathways, to facilitate uptake and follow-up. Further development of this, or other interventions, is needed to enable wider, and more socially diverse, engagement of people at risk. Balancing a locality and individual practice approach, and how this is resourced are considerations for long-term sustainability.https://bmjopen.bmj.com/content/9/8/e028491.full |
| spellingShingle | Thomas Yates Joe Kai Navneet Aujla Helen Dallosso Users’ experiences of a pragmatic diabetes prevention intervention implemented in primary care: qualitative study BMJ Open |
| title | Users’ experiences of a pragmatic diabetes prevention intervention implemented in primary care: qualitative study |
| title_full | Users’ experiences of a pragmatic diabetes prevention intervention implemented in primary care: qualitative study |
| title_fullStr | Users’ experiences of a pragmatic diabetes prevention intervention implemented in primary care: qualitative study |
| title_full_unstemmed | Users’ experiences of a pragmatic diabetes prevention intervention implemented in primary care: qualitative study |
| title_short | Users’ experiences of a pragmatic diabetes prevention intervention implemented in primary care: qualitative study |
| title_sort | users experiences of a pragmatic diabetes prevention intervention implemented in primary care qualitative study |
| url | https://bmjopen.bmj.com/content/9/8/e028491.full |
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