scholarly journals Development of Healthy Eating and Active Lifestyles for Diabetes (HEAL‐D), a culturally‐tailored diabetes self‐management education and support programme for black‐British adults: a participatory research approach

2021 ◽  
Author(s):  
Louise M. Goff ◽  
Amanda P. Moore ◽  
Seeromanie Harding ◽  
Carol Rivas
Keyword(s):  
Participatory Research ◽  
Healthy Eating ◽  
Management Education ◽  
Self Management ◽  
Research Approach ◽  
Black British ◽  
Support Programme ◽  
Culturally Tailored ◽  
Active Lifestyles ◽  
Participatory Research Approach

scholarly journals Healthy Eating and Active Lifestyles for Diabetes (HEAL-D), a culturally tailored self-management education and support program for type 2 diabetes in black-British adults: a randomized controlled feasibility trial

2021 ◽  
Vol 9 (1) ◽  
pp. e002438
Author(s):  
Louise M Goff ◽  
Carol Rivas ◽  
Amanda Moore ◽  
Nicholas Beckley-Hoelscher ◽  
Fiona Reid ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Healthy Eating ◽  
Management Education ◽  
Feasibility Trial ◽  
Self Management ◽  
Black British ◽  
Randomized Controlled ◽  
Culturally Tailored ◽  
Active Lifestyles

IntroductionBlack-British communities are disproportionately affected by type 2 diabetes (T2D). Structured education programs are a core component of T2D healthcare but they are less successful in people from minority ethnic groups. Culturally tailored T2D education has demonstrated greater benefits than usual care. The aim of our study was to evaluate acceptability, fidelity and trial feasibility of the Healthy Eating and Active Lifestyles for Diabetes (‘HEAL-D’) culturally tailored T2D self-management education and support (DSMES) program.Research design and methodsA mixed-methods randomized controlled feasibility trial in black-British adults with T2D was conducted. Participants were assigned to control (usual care) or intervention (HEAL-D; 7 sessions, 14 hours of group-based culturally tailored diet and lifestyle education, behavior change support and supervised physical activity), in a ratio of 1:1. Primary outcomes were recruitment and retention rates, intervention attendance and completion. Fidelity was assessed through observations and qualitative evaluation was undertaken with participants and educators.Results102 patients responded to invitation letters (n=1335); 63 were randomized but 8 were subsequently deemed ineligible due to high baseline glycosylated hemoglogin (HbA1c) requiring intensive medical management or missing baseline HbA1c measurement. Of the remaining 55 participants (27 intervention, 28 control), 69% were female, 47% were of African and 51% were of Caribbean ethnicity. 93% completed the trial, providing end point data. Intervention attendance was high; 85% completed the program (attendance at ≥5 sessions), and 74% attended ≥6 sessions. The intervention was delivered with acceptable fidelity, although the qualitative evaluations identified some areas of structure and format in need of refinement.ConclusionsWe have shown it is feasible to recruit and randomize black-British adults with T2D to a trial of a culturally tailored DSMES program. We have shown the intervention is highly acceptable for both patients and healthcare providers. A future trial should assess clinical and cost-effectiveness of HEAL-D.Trial registration numberNCT03531177.

scholarly journals Healthy Eating and Active Lifestyles for Diabetes (HEAL-D): study protocol for the design and feasibility trial, with process evaluation, of a culturally tailored diabetes self-management programme for African-Caribbean communities

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023733 ◽  
Author(s):  
Louise M Goff ◽  
Amanda P Moore ◽  
Carol Rivas ◽  
Seeromanie Harding
Keyword(s):  
Process Evaluation ◽  
Healthy Eating ◽  
Complex Interventions ◽  
Management Programme ◽  
Feasibility Trial ◽  
Self Management ◽  
Effectiveness Trial ◽  
Black British ◽  
Culturally Tailored ◽  
Active Lifestyles

IntroductionBlack British communities are disproportionately burdened by type 2 diabetes (T2D) and its complications. Tackling these inequalities is a priority for healthcare providers and patients. Culturally tailored diabetes education provides long-term benefits superior to standard care, but to date, such programmes have only been developed in the USA. The current programme of research aims to develop the Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) culturally tailored T2D self-management programme for black British communities and to evaluate its delivery, acceptability and the feasibility of conducting a future effectiveness trial of HEAL-D.Methods and analysisInformed by Medical Research Council Complex Interventions guidance, this research will rigorously develop and evaluate the implementation of the HEAL-D intervention to understand the feasibility of conducting a full-scale effectiveness trial. In phase 1, the intervention will be developed. The intervention curriculum will be based on existing evidence-based T2D guidelines for diet and lifestyle management; codesign methods will be used to foster community engagement, identify the intervention’s underpinning theory, identify the optimal structure, format and delivery methods, ascertain adaptations that are needed to ensure cultural sensitivity and understand issues of implementation. In phase 2, the intervention will be delivered and compared with usual care in a feasibility trial. Process evaluation methods will evaluate the delivery and acceptability of HEAL-D. The effect size of potential primary outcomes, such as HbA1c and body weight, will be estimated. The feasibility of conducting a future effectiveness trial will also be evaluated, particularly feasibility of randomisation, recruitment, retention and contamination.Ethics and disseminationThis study is funded by a National Institute of Health Research Fellowship (CDF-2015-08-006) and approved by National Health Service Research Ethics Committee (17-LO-1954). Dissemination will be through national and international conferences, peer-reviewed publications and local and national clinical diabetes networks.Trial registration numberNCT03531177; Pre-results.

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