Abstract
BackgroundStructured education for people with type 2 diabetes improves outcomes, but uptake is low globally. In the United Kingdom in 2016, only 8.3% of people who were referred to education programs attended the program. We have developed a Web-based structured education program named Healthy Living for People with type 2 Diabetes (HeLP-Diabetes): Starting Out (HDSO), as an alternative to face-to-face courses. A Web-based program gives people more options for accessing structured education and may help improve overall uptake.ObjectiveThe aim was to explore the feasibility and acceptability of delivering a Web-based structured education program (named HeLP-Diabetes: Starting Out) in routine primary health care and its potential impact on self-efficacy and diabetes-related distress.MethodsHDSO was delivered as part of routine diabetes services in primary health care in the United Kingdom, having been commissioned by local Clinical Commissioning Groups. Quantitative data were collected on uptake, use of the program, demographic characteristics, self-reported self-efficacy, and diabetes-related distress. A subsample of people with type 2 diabetes and health care professionals were interviewed about acceptability of the program.ResultsIt was feasible to deliver the program, but completion rates were low: of 791 people with type 2 diabetes registered, only 74 (9.0%) completed it. Completers improved their self-efficacy (change in median score 2.5, P=.001) and diabetes-related distress (change in median score 6.0, P=.001). Interview data suggested that the course was acceptable, and that uptake and completion may be related to nonprioritization of structured education.ConclusionsThe study provides evidence of the feasibility and acceptability of a Web-based structured education. However, uptake and completion rates were low, limiting potential population impact. Further research is needed to improve completion rates, and to determine the relative effectiveness of Web-based versus face-to-face education.
Highlights
BackgroundDiabetes self-management education (DSME) aims to help people develop the knowledge and skills to manage their physical and emotional health [1]
A 2013 Cochrane systematic review of computer-based diabetes self-management interventions found a small effect on glycemic control, which was larger in the mobile phone app subgroup [7]
We developed a Web-based structured education program for people with type 2 diabetes mellitus (T2DM), called Healthy Living for People with type 2 Diabetes (HeLP-Diabetes): Starting Out (HDSO)
Summary
BackgroundDiabetes self-management education (DSME) aims to help people develop the knowledge and skills to manage their physical and emotional health [1]. Reviews of Web-based diabetes self-management interventions are promising, but there are challenges including low uptake and engagement, that can limit effectiveness and need further research [18]. We have developed a Web-based structured education program named Healthy Living for People with type 2 Diabetes (HeLP-Diabetes): Starting Out (HDSO), as an alternative to face-to-face courses. Objective: The aim was to explore the feasibility and acceptability of delivering a Web-based structured education program (named HeLP-Diabetes: Starting Out) in routine primary health care and its potential impact on self-efficacy and diabetes-related distress. Results: It was feasible to deliver the program, but completion rates were low: of 791 people with type 2 diabetes registered, only 74 (9.0%) completed it Completers improved their self-efficacy (change in median score 2.5, P=.001) and diabetes-related distress (change in median score 6.0, P=.001). Further research is needed to improve completion rates, and to determine the relative effectiveness of Web-based versus face-to-face education
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