Discussion of Challenges in Engaging Urdu/Punjabi Speak People with Type 2 Diabetes in Structured Group Patient Education Using Interpretation and Established Educational Tools in Two Health Boards in Scotland

Abstract

IntroductionPeople from black and minority ethnic (BME) communities who live in upper-middle and high income countries [1] are at higher risk of type 2 diabetes than white Caucasians and they develop this at lower clinical points than white Caucasians [2,3]. A Scottish survey found that Scottish Pakistani and Indian people with type 2 diabetes were more likely to have poor diabetes control compared to white Scottish people with type 2 diabetes [4] and the Scottish Diabetes Action Plan (2010) aimed to address these inequities [5].Scotland's health is managed through 14 Boards and each Board has a disease specific Managed Clinical Network (MCN). The BME population in Scotland is concentrated mainly in the large cities of Glasgow, Edinburgh, Aberdeen and Dundee, spanning 4 of the 14 MCNs with smaller numbers dispersed across the rest of Scotland. The BME Scottish population is 4% [6] and the largest category is from Asia (3%) [6].Education and information, as well as being tailored to individuals' culture and beliefs, have been identified as two of the key themes necessary to support self-management for people with long-term-conditions [7]. MCNs within each Health Board are responsible for ensuring that culturally appropriate care is provided for people from the BME communities.Culturally appropriate care is defined as 'health education tailored to the cultural or religious beliefs and linguistic and literacy skills of the community being studied' [8]. A literature review identified two aspects to culturally appropriate care: one focuses on values, beliefs, traditions and language of a people group that may not meet the specific needs of individuals [9]. The second approach explains an individual's health status according to their social status rather than by their beliefs and behaviours. This second approach is considered as cultural safety and there is limited evidence of its use in health care. This paper considers culturally appropriate care within the context of language, beliefs and traditions. AbstractAim: Structured patient education is one aspect of supporting selfmanagement for people with diabetes. People from the black and minority ethnic groups who live in upper-middle and high income countries are at higher risk of developing type 2 diabetes mellitus than white Caucasians and providing structured patient education in a multicultural society can be challenging for practitioners. To promote a sustainable model of care, with language support, this paper discusses the use of culturally appropriate structured patient education with established tools within routine care.Methods: Structured patient education was provided for people with type 2 diabetes from the Urdu/Punjabi speaking communities in two Health Boards in Scotland during 2013 with language support. Diabetes Nurse Specialists and Practice Nurses with expertise in delivering structured patient education delivered Conversation Maps TM , as part of routine care, using Linkworkers in Lothian Health Board and Interpreters in Greater Glasgow and Clyde ...

Digital enabled learning for people with diabetes postCOVID‐19 pandemic

“…Undertaking digitally-enabled education at a time and a place that may be more convenient for PWD may overcome some of the known barriers to attending current educational provision such as: shame and stigma of diabetes; 22 logistics; medical or financial reasons; cultural reasons; 23 and time away from work or studies. 24,25 However, even with digital education, ongoing engagement tended to wane with time. 8,17,18,26 A systematic review and metaanalysis published in 2021 found that digital health-led DSMEs were effective in improving glucose control and diabetes knowledge.…”