Goff Louise M, Moore Amanda P, Harding Seeromanie, Rivas Carol
Departments of Diabetes & Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
Department of Social Science, University College London, London, UK.
Diabet Med. 2021 Nov;38(11):e14594. doi: 10.1111/dme.14594. Epub 2021 Jun 7.
To develop an evidence-based, culturally tailored, diabetes self-management education and support programme for Black-British adults, called Healthy Eating and Active Lifestyles for Diabetes (HEAL-D), using participatory methods to engage key stakeholders in the intervention design process.
Black-British adults living with type 2 diabetes, healthcare professionals and community leaders were engaged in an intervention development study. The intervention structure, format, content and delivery were developed through three phases of participatory research: Phase 1, formative research, involved focus groups and interviews; interactive co-development workshops were conducted in Phase 2; and Phase 3 focused on materials development.
In Phase 1, focus groups and interviews identified the importance of nurturing collectivism, a reliance on informal sources of information/advice, barriers to attending appointments associated with competing priorities of work, travel and carer commitments, and a preference for directness and simple, clear advice/messages. A priority for healthcare professionals was the intervention embedding within current primary care structures and aligning with incentivised targets/metrics. Phase 2 (workshops) highlighted key requirements: avoidance of medical settings, appropriately trained and culturally knowledgeable educators, flexible appointments, preference for verbal and visual information and avoidance of technical/medical terminology. In Phase 3 (materials development), culturally sensitive videos, short films and information booklets were developed to convey educational messages, and food photography was used to provide culturally relevant dietary advice.
Participatory methods provide a means to understand the needs of specific communities. This approach enables the development of healthcare interventions that are sensitive to the needs of service users and providers.
为英国黑人成年人开发一个基于证据、符合文化特点的糖尿病自我管理教育与支持项目，名为“糖尿病健康饮食与积极生活方式”（HEAL-D），采用参与式方法让关键利益相关者参与干预设计过程。
患有2型糖尿病的英国黑人成年人、医疗保健专业人员和社区领袖参与了一项干预开发研究。干预的结构、形式、内容和实施通过三个参与式研究阶段来制定：第一阶段，形成性研究，包括焦点小组和访谈；第二阶段进行互动式共同开发研讨会；第三阶段专注于材料开发。
在第一阶段，焦点小组和访谈确定了培养集体主义的重要性、对非正式信息/建议来源的依赖、与工作、出行和照顾者责任等相互竞争的优先事项相关的就诊障碍，以及对直接性和简单、明确的建议/信息的偏好。医疗保健专业人员的一个优先事项是将干预措施融入当前的初级保健结构，并与激励性目标/指标保持一致。第二阶段（研讨会）突出了关键要求：避免医疗环境、有适当培训且具备文化知识的教育者、灵活的预约、对口头和视觉信息的偏好以及避免使用技术/医学术语。在第三阶段（材料开发），制作了具有文化敏感性的视频、短片和信息手册来传达教育信息，并使用食物摄影提供与文化相关的饮食建议。
参与式方法提供了一种了解特定社区需求的途径。这种方法能够开发出对服务使用者和提供者的需求敏感的医疗保健干预措施。
