3073 Development and implementation of a faith-based community Health Advocate training programme for type-2 diabetes remission: A model for community-based non-communicable disease control

Abstract

OBJECTIVES/SPECIFIC AIMS: The aim of this study is two-fold (1) to include a participatory action research design in the development of a community-based health advocate (HA) training programme which empowers community members to support the Barbados diabetes remission study 2 protocol – a low-calorie intervention for T2DM remission (2) to study the implementation of this programme with in select faith-based organisations (FBOs) which will act as community hubs. METHODS/STUDY POPULATION: Translation was informed using the RE-AIM framework. The target population were members of select FBOs. We assessed the readiness of FBOs to become community hubs in relation to human resources (the HA team must include someone with a clinical degree), infrastructure capacity (a private room for interviews) and the perspective (knowledge and attitude) of the FBO leadership to both the training and diabetes remission programmes. An open recruitment for HAs was made to the FBO membership and all who responded were accepted to the programme; which consisted of 8 weeks of face to face sessions inclusive of lectures and practical demonstrations and exercises specific to NCDs e.g. assessment of basic clinical parameters, ethics and nutrition. This was followed by a simulation exercise and a formal objective structured clinical examination (OSCE). HAs will participate in focus groups aimed at exploring the barriers and facilitators to the use of social media as a support system; this will be followed by participatory design workshops where the HAs will design support systems, inclusive of social media support, to assist participants in the diabetes remission intervention. RESULTS/ANTICIPATED RESULTS: All three FBOs that were approached responded favourably and the programme was described as ‘necessary’ and ‘timely’ by the leadership. The FBOs were assessed and found to be ready. Thirty-eight persons signed up for the programme (more than the 21 we anticipated); 31 (82%) attended at least 1 session and 29 completed the training; this indicates that implementation in the community is feasible. All who completed the programme attained an overall passing grade indicating the effectiveness of, and fidelity to the training. Initial feedback on the programme from HAs and volunteers indicates that it was acceptable. DISCUSSION/SIGNIFICANCE OF IMPACT: This community-based training programme was successful in terms of reach, as both the FBO and the individual HA responded favourably; and effectiveness as measured by the expanded skill set of the HA. Initial feedback suggests that implementation of the programme is feasible in the community and acceptable to the HAs. Although this model focusses on diabetes remission utilising FBOs as hubs, it can be easily adapted to other NCDs e.g. hypertension and mental health; other disciplines e.g. surveillance; and other communities e.g. workplaces, homeless shelters.