Title: A pilot study to examine the feasibility of improving engagement with supported self-management in diabetic patients in disadvantaged populations.
Funder: Department of Health (England)

Abstract: Background Type 2 diabetes (DM) is a disorder of glucose metabolism. Patient self care is critical for the control of the disorder National & local evaluations show that structured education programmes such as X-PERT can improve self care. However, these programmes do not reach people from disadvantaged communities. It is important to evaluate interventions aimed at improving support for these communities We will use Health Trainers to help disadvantaged people with Type 2 DM engage with self care support. Health trainers are people from the local community trained to help patients change behaviours using evidence-based methods. They will conduct a structured interview with patients to develop an personal management plan using a locally developed menu of options; & provide ongoing patient support Aims (1) Intervention development: engage with patients & practitioners in NHS Blackpool to explore views on the needs of people from disadvantaged areas to develop a Health Trainer intervention that can effectively encourage patients with diabetes from disadvantaged communities to engage with self care support (2) Evaluation: to assess the feasibility of delivering that intervention and evaluating its effects in a pilot RCT (i) Feasibility of collecting data using face-to-face and telephone for these hard to reach groups (ii) Collect basic resource use data (primary and secondary care) and to to estimate the cost of the . intervention (3) Undertake a qualitative evaluation of the intervention (4) Disseminate results within local NHS Plan of Investigation 1. Focus groups with GPs, HTs and DM patients to discuss gaps in current provision for disadvantaged populations, to refine intervention and to develop a local menu of options for DM patients. 2. Pilot study: To test a complex intervention, designed for people with type 2 DM to improve patient self-management behaviours, self-confidence & control, DM control and HRQoL as measured by a researcher-delivered questionnaire. The intervention is a structured interview with a Health Trainer to develop an individually tailored self-management plan, with ongoing HT support for 6 months. We aim to recruit 2 large general practices in socioeconomically disadvantaged areas. 3. Gather basic cost and resource use data 4. Conduct qualitative interviews with participants to evaluate the intervention. Potential Impact This study will develop an intervention suitable for use with people from disadvantaged areas & with poor basic skills.This will subsequently be evaluated in a large-scale RCT. If the intervention shows a benefit it will be implemented across the PCT leading to (1) better DM self-management & health in people with type 2 DM (2) patients who are empowered to take more control of their health & (3) a potential role and additional training for Health Trainers to support people with type 2 DM. Benefits to patients: Impacts (1) & (2) will enable type 2 DM patients previously missed by traditional group interventions and those with poor health literacy skills to better understand & self-manage their condition. Benefits to NHS: Impacts (2) & (3) will lead to reduced health care costs


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: METABOLIC AND ENDOCRINE