Understanding the intervention context: exploring barriers and facilitators to attendance at diabetes structured education programmes

Abstract

Background: A research prioritisation process conducted with people with diabetes, health professionals and policy makers, identified low attendance at structured education for Type 2 diabetes (T2DM) as a priority area for research in Ireland. The aim of this study was to explore barriers and facilitators to attendance at T2DM structured education programmes in Ireland. Methods: People with T2DM who had attended, or been invited to attend, at one of the three structured education programmes (CODE, DESMOND and X-PERT) and educators from the three programmes took part in semi-structured telephone interviews. Interviews were audio-taped, transcribed and analysed using inductive thematic analysis. Findings: 15 people with T2DM and 14 educators were interviewed. People with T2DM described a lack of information at initial diagnosis but were overwhelmingly positive about their experience of structured education programmes. Reasons for non-attendance included not knowing programmes were available, not appreciating the potential benefits, and not wanting to admit to the reality of diabetes. Analysis also identified innovations to increase attendance developed by educators in different areas, and the key role of healthcare professionals in promoting structured education. Discussion: People with T2DM see clear benefits of structured education after attending but need information and encouragement from their healthcare team to support attendance. The innovative strategies developed by educators across the country to promote structured education could be better communicated and standardised nationally. The findings of this study will be discussed in relation to the best use of qualitative research to understand the context for intervention development.