HEAL-D Online: Exploring the potential for the spread and adoption of a virtual culturally tailored diabetes self-management programme for adults of African and Caribbean heritage

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics Pub Date : 2024-11-25 DOI:10.1111/jhn.13396

Sophie Lowry, Joseph Low, Louise Goff, Sally Irwin, Nick Sevdalis, Pearl Okeke, Oliver Brady, Natasha Curran, Andrew Walker

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引用次数: 0

Abstract

Background

People of African and Caribbean heritage in the UK have a higher prevalence of Type 2 Diabetes (T2D) and poorer health outcomes than white Europeans. Healthy Eating and Active Lifestyles for Diabetes Online (HEAL-D Online) is a co-designed, culturally tailored T2D self-management programme for black African and Caribbean adults, which, due to online delivery, is well positioned for spread. This qualitative evaluation uses the Exploration-Preparation-Implementation-Sustainment (EPIS) framework to explore factors affecting scale-up from delivery and commissioning perspectives.

Methods

Semi-structured interviews were conducted with nine commissioners and providers of T2D services from three English areas with varying population characteristics to explore scale-up. Focus groups were held with 15 people of African and Caribbean heritage with T2D lived experience to explore the impact of a digital model of participation. Data were analysed using thematic analysis, with themes mapped onto the EPIS framework exploration phase constructs to consider the outer and inner contextual factors for planning implementation.

Results

Six EPIS constructs were identified by commissioners and providers as key in scaling HEAL-D Online. People with T2D lived experience explored the online mode of delivery, using the patient advocacy construct as the analytical lens. In delivering an online T2D programme, two themes were identified: (1) aligning course content with people's preferences; (2) practicalities to ensure online delivery was acceptable and accessible to the community.

Conclusions

HEAL-D Online was acceptable with the potential to help address health inequalities. The EPIS framework provided a structure to understand factors in planning scale-up for an intervention targeting underserved communities.

查看原文本刊更多论文

HEAL-D 在线：探索针对非裔和加勒比裔成年人的、具有文化针对性的糖尿病自我管理虚拟计划的传播和采用潜力。

背景：与欧洲白人相比，英国非洲裔和加勒比裔 2 型糖尿病（T2D）发病率更高，健康状况更差。糖尿病健康饮食与积极生活方式在线计划（HEAL-D Online）是一项针对非洲黑人和加勒比海地区成年人的共同设计、文化定制的 T2D 自我管理计划，由于采用了在线交付的方式，因此非常适合推广。这项定性评估采用探索-准备-实施-持续（EPIS）框架，从实施和委托的角度探讨影响推广的因素：对来自英国三个不同人口特征地区的九名 T2D 服务委托人和提供者进行了半结构化访谈，以探讨推广问题。与 15 名具有 T2D 生活经验的非洲和加勒比遗产人士进行了焦点小组讨论，以探讨数字参与模式的影响。采用主题分析法对数据进行了分析，并将主题映射到 EPIS 框架探索阶段的构造上，以考虑规划实施的外部和内部环境因素：结果：委托方和提供方确定了六项 EPIS 构建，认为它们是推广 HEAL-D Online 的关键。有 T2D 生活经验的人以患者权益为分析视角，探索了在线实施模式。在实施 T2D 在线课程时，确定了两个主题：(1) 根据人们的偏好调整课程内容；(2) 实用性，以确保在线授课可以被社区接受和使用：结论：HEAL-D 在线课程是可以接受的，具有帮助解决健康不平等问题的潜力。EPIS框架提供了一个结构，可用于了解针对服务不足社区的干预措施的推广规划中的各种因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Human Nutrition and Dietetics 医学-营养学

CiteScore

5.30

自引率

15.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on: - Clinical nutrition and the practice of therapeutic dietetics - Clinical and professional guidelines - Public health nutrition and nutritional epidemiology - Dietary surveys and dietary assessment methodology - Health promotion and intervention studies and their effectiveness - Obesity, weight control and body composition - Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments. - Appetite, Food intake and nutritional status - Nutrigenomics and molecular nutrition - The journal does not publish animal research The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.