Individuals with lower income and less education are two to four times more likely to develop diabetes than more advantaged individuals. In response to this, there is a need for developing health promotion activities targeting hardly reached populations. The aim of this study was to examine the perspectives of hardly reached people with type 2 diabetes on patient education, focusing on their wishes and needs regarding format and approach. Data were collected through qualitative interviews with nine individuals with type 2 diabetes with little or no education and characterized as hardly reached patients by health professionals. Interviews were transcribed verbatim and analyzed according to systematic text condensation. We identified four main categories of preferences for patient education: 1) flexibility related to start time, duration, and intensity; 2) simple and concrete education tools, with regard to design and extent; 3) being together, related to meeting people in a similar situation; and 4) respectful educators, related to constructive patient–educator relationships. Insights into the preferences of hardly reached people with diabetes can contribute to the development of appropriately tailored patient education for this patient group.

Rationale, aims and objective: Most patient education is based on a professional understanding of patients’ needs for learning, rather than a patient perspective. This generates a risk of neglecting issues that are important to patients, but unrecognised by educators. The aim of this study was to develop a health educational model for group-based patient education in chronic illness based on patient-perceived challenges.Methods: Design Thinking was used as a method of inquiry. Four interactive workshops with 25 Danish patients with Type 2 diabetes, heart disease and chronic obstructive pulmonary disease provided data on patient-perceived challenges. Workshops with 28 educators informed the development of the model. A constant comparative method was used for analyses.Results: Patients with chronic illness experience a constant need to balance their lives, which imposes new challenges in their everyday life. We identified 4 main challenges: Bodily Infirmities, Lowered Expectations, Challenging Relations and Changeable Moods. In response to these challenges, researchers and educators developed The Balancing Person, a health educational model with 4 interconnected meta-needs for the education process: Wholeness, Clarity, Timeliness and Connectedness.

Purpose – The purpose of this paper is to explore educator competencies and roles needed to perform participatory patient education, and develop a comprehensive model describing this. Design/methodology/approach – Data collection in the qualitative study proceeded through two phases. In the first phase, 28 educators were involved in exploring educator competencies needed to perform participatory, group-based patient education. The paper used qualitative methods: dialogue workshops, interviews and observations. In the second phase, 310 educators were involved in saturating and validating the insights from phase one using workshop techniques such as brainstorming, reflection exercises and the story-dialogue method. A grounded theory approach was used to analyse data. Findings – A model called “The Health Education Juggler” was developed comprising four educator roles necessary to perform participatory patient education: the Embracer, the Facilitator, the Translator and the Initiator. The validity of the model was confirmed in phase two by educators and showed fit, grab, relevance, workability and modifiability. Practical implications – The model provides a tool that can be used to support the focus on “juggling” skills in educators: the switching between different educator roles when performing participatory, group-based patient education. The model is useful as an analytical tool for reflection and supervision, as well as for observation and evaluation of participatory, group-based patient education. Originality/value – The study proposes a comprehensive model consisting of four equally important roles for educators performing participatory, group-based patient education.

Some patients do not benefit from participation in patient education due to reasons related to disease burden, literacy, and socioeconomic challenges. In this communication, we address more specifically both the challenges that these hardly reached patients face in relation to patient education programs and the challenges educators face when conducting patient education with hardly reached patients. We define principles for the format and content of dialogue tools to better support this patient group within the population of individuals with diabetes.