“What’s the Point?”: Understanding Why People With Type 2 Diabetes Decline Structured Education

Abstract

Structured diabetes education (SDE) is an evidencebased intervention that supports self-management in people with type 2 diabetes. In the United Kingdom, health care providers working in primary care settings are responsible for referring people with type 2 diabetes to SDE programs. However, national audits record a high percentage of nonattenders. We explored the personal experience of living with type 2 diabetes that led to individuals declining invitations to attend SDE programs. The themes suggested that emotional, cognitive, and social issues related to diagnosis and living with diabetes may be responsible for declining to attend SDE and that these factors may be masked by explanations of practical barriers. A person-centered approach to understanding the personal meaning of being diagnosed and living with type 2 diabetes may help to identify individuals' psychosocial barriers to attending SDE.

A qualitative study exploring the barriers to attending structured education programmes among adults with type 2 diabetes

“…This finding is congruent with the ‘ enabling factors’ category of ABM which outlines that the availability and nature of support can facilitate or impede health service utilisation [ 19 ]. However, it contrasts with previous findings in the field which have found lack of support and poor physician-patient relationships as barriers to attendance [ 32 ]. Our findings may be explained by a study by Gucciardi and colleagues [ 33 ] which found that some individuals perceive primary care physicians to provide the same coverage of diabetes education and lifestyle modification skills training as DSME.…”

Influences of decisions to attend a national diabetes prevention programme from people living in a socioeconomically deprived area

“…11,14 The key role that GPs and other frontline professionals play has also been identified in other research on attendance at Type 2 diabetes education programmes. [31][32][33][34] One of the strengths of this study is collection of data from a high number of non-attenders, who are usually difficult to recruit. 1,15 We also recruited a sample including individuals from a socioeconomically deprived area, which is a known risk factor for T2DM.…”

“…Collaborative working between community and clinical services is needed to ensure programmes like the NHSDPP are effectively implemented 11,14 . The key role that GPs and other frontline professionals play has also been identified in other research on attendance at Type 2 diabetes education programmes 31‐34 …”

A novel information sharing framework for people living with type-2 diabetes in the context of a group education program

“…Diabetes education has also been a focus of many prior studies. Diabetes education is a specific intervention that supports diabetes self-management [ 19 ]. A systematic review and meta-analysis indicate that diabetes education improves clinical, lifestyle, and psychological outcomes for type-2 diabetic patients compared to usual care [ 20 ].…”