Sharing stories: complex intervention for diabetes education in minority ethnic groups who do not speak English

Abstract

Objective To develop and refine a complex intervention for diabetes support and education in minority ethnic groups, delivered through bilingual health advocates.

Multifaceted guideline implementation strategies improve early identification and management of osteoporosis

“…This concurs with other published research into guideline implementation, which highlights that there is no one effective strategy, and that multiple strategies are required to change cultures and behaviours. [20][21][22][23][24] Grol et al 25 discussed this issue of single or multifaceted interventions in changing professional behaviour and implementing guidelines to best practice. They stated that numerous intervention strategies and measures can be used to change behaviour and implement innovation.…”

“…17,18,[20][21][22][23] Based on our knowledge of current performance in the hospital site, 19 we not only identified opportunities for improvement, but also ways in which improvement could occur. Then we made a concerted effort over 6 months from August 2006, to increase awareness of, and compliance with, the osteoporosis guideline recommendations.…”

“…This assisted her to tailor the way in which messages were delivered to different audiences. 22,23 To do this she first developed an organisational chart to identify all relevant stakeholders within the hospital outpatient clinics and the primary health care environment surrounding the hospital. She then surveyed these stakeholders (including patients), before rolling out the guidelines (JuneJuly 2006).…”

“…Implementation of any guideline or protocol is about understanding local drivers for change, local barriers to uptake of better practices, negotiating around these barriers, and compromising on appropriate ways of operationalising change. 18,[20][21][22][23] The change champion thus attempted, in the third step, to understand each stakeholder' s perspective and values relating to the implementation of guideline recommendations in each area of practice. This assisted her to tailor the way in which messages were delivered to different audiences.…”

“…We recognised that the needs and perspectives of the different stakeholders, their educational backgrounds, and their health philosophies could influence their current and future behaviours, as well as the way they changed behaviours. Thus in the penultimate step, we developed and implemented multifaceted approaches which addressed the Think, Do, Plan, Act cycle [23][24][25] as relevant to each stakeholder. The separate facets are outlined below.…”