Investigating health professionals' perspectives and experiences of food security-related conversations in diabetes care.

AIMS

Household food insecurity (FI) is a serious public health concern and disproportionately affects people living with chronic health conditions, undermining diabetes self-management. Little is known about healthcare professionals' (HCPs) experiences of supporting people affected by diabetes and FI, and no national guidelines incorporate consideration of FI within UK diabetes care. A qualitative study of NHS HCPs' consideration of FI within diabetes care, and the extent to which it informs their clinical practice, was undertaken.

METHODS

Fifteen HCPs providing self-management support to people with Type 1 or Type 2 diabetes in a Scottish Health Board took part in semi-structured interviews. Data were analysed using a thematic framework approach informed by the Capability, Opportunity, Motivation and Behaviour (COM-B) model of behaviour change.

RESULTS

Although the potential impact of FI on diabetes self-management was recognised, this important consideration was not currently core to their clinical practice. Enablers and barriers identified included: personal feelings about raising the issue, lack of knowledge of available resources, the patient-practitioner relationship, and the wider socioeconomic environment. Practical suggestions to support HCPs included: specific training on communication, access to patient support information, use of a screening tool to assess FI, and building NHS-third sector links.

CONCLUSIONS

Our findings provide insight into cognitive factors, emotional processes and environmental systems impacting on HCPs' practice supporting individuals with diabetes and FI. Research with affected patients is needed to gain a better understanding of how to provide support within NHS settings.