Establishing a multi-sectoral community allied health service for type 2 diabetes: Logan Healthy Living (Preprint)
Authors: Gomersall Sjaan Rhonda , Giguere Denis Y , Cotugno Jacqueline , Munro Joanna , Westbrook Wallis J , Littlewood Robyn , Cairney John , Winkler Elisabeth AH , van der Vliet Philip M , Goode Ana D , Alsop Tahlia , Healy Genevieve Nissa 
Published: December 2024

BACKGROUND

Type 2 diabetes is the fastest growing chronic condition in Australia with higher prevalence in disadvantaged groups. Logan Healthy Living by UQ Health Care is a proof-of-concept, interprofessional allied health clinic focused on supporting people with and at risk of type 2 diabetes in Logan, a region in South-East Queensland, Australia with high levels of health inequity. Logan Healthy Living is supported by the Queensland Government through Health and Wellbeing Queensland and a broader multi-sectoral alliance including primary health care, tertiary hospital and health services, government, community and university sectors.

OBJECTIVE

This paper describes the establishment of Logan Healthy Living and outlines the evaluation protocol for the service’s type 2 diabetes lifestyle management program.

METHODS

The context and setting of Logan are presented, and the process for establishing the multi-sectoral partnerships, development and governance of the service and the facility are described. The lifestyle management program is an 8-week, group-based program, which includes one hour of education and one hour of supervised, individually tailored exercise each week. The theoretical underpinnings and the program are described in detail. The RE-AIM framework will guide evaluation of the program and inform key questions regarding: Reach (number and characteristics of clients); Effectiveness (diabetes-related distress, health behaviours [physical activity and diet], quality-of-life, self-management self-efficacy, loneliness, community involvement, anthropometric measures, HbA1c, physical function and healthcare utilisation); Adoption (referral pathways); Implementation (fidelity, appropriateness, acceptability, costs); and, Maintenance (long term effectiveness). Data will be drawn from a purposefully embedded minimum dataset and Data Registry, with the process for designing and embedding data collection into practice (via surveys; in-person measures; client management software) described in detail.

RESULTS

Ethics has been obtained for the Data Registry. Logan Healthy Living is a 4-year proof of concept, which concludes 31 December 2024, with findings expected to be reported from 2025. Interim bi-annual key performance indicators reports have informed iterative service developments, including structure of appointments, ongoing access to resources and increased social opportunities.

CONCLUSIONS

While multi-sectoral responses are needed for complex community health challenges, processes for achieving this are rarely documented and the description of the development of Logan Healthy Living has the potential to inform future partnerships. The findings from the evaluation will provide important new knowledge on the impact of a community-delivered type 2 diabetes program on individuals, the community, and the health system, in an area of high health inequity.