Abstract
Aims: The DAFNEplus programme seeks to promote sustained improvements in glycaemic management by incorporating techniques from behavioural science. It includes five sessions of structured individual support delivered over 12-months following group education. As part of a broader evaluation, and to inform decision-making about roll-out in routine care, we explored participants’ experiences of, and engagement with, that individual support.
Methods: We interviewed DAFNEplus participants (n=28) about their experiences of receiving individual support and the impact they perceived it as having on their self-management practices. We analysed data thematically.
Results: Participants described several important ways individual support had helped strengthen their self-management, including: consolidating and expanding their understandings of flexible intensive insulin therapy; promoting ongoing review and refinement of behaviour; encouraging continued and effective use of data; and, facilitating access to help from healthcare professionals to pre-empt or resolve emergent difficulties. Participants characterised themselves as moving towards independence in self-management over the time they received individual support, with their accounts suggesting three key stages in that journey: ‘Working with healthcare professionals’; ‘Growing sense of responsibility’; and, ‘Taking control’. Whilst all portrayed themselves as changed, participants’ progress through those stages varied; a few continued to depend heavily on DAFNEplus facilitators for advice and/or direction at 12-months.
Conclusions: Whilst all participants benefited from individual support, our findings suggest that some may need, or gain further benefit from, longer-term, tailored support. This has important implications for decision-making about roll-out of DAFNEplus post-trial, and for development of future programmes seeking to bring about sustainable changes in self-management practices.
Methods: We interviewed DAFNEplus participants (n=28) about their experiences of receiving individual support and the impact they perceived it as having on their self-management practices. We analysed data thematically.
Results: Participants described several important ways individual support had helped strengthen their self-management, including: consolidating and expanding their understandings of flexible intensive insulin therapy; promoting ongoing review and refinement of behaviour; encouraging continued and effective use of data; and, facilitating access to help from healthcare professionals to pre-empt or resolve emergent difficulties. Participants characterised themselves as moving towards independence in self-management over the time they received individual support, with their accounts suggesting three key stages in that journey: ‘Working with healthcare professionals’; ‘Growing sense of responsibility’; and, ‘Taking control’. Whilst all portrayed themselves as changed, participants’ progress through those stages varied; a few continued to depend heavily on DAFNEplus facilitators for advice and/or direction at 12-months.
Conclusions: Whilst all participants benefited from individual support, our findings suggest that some may need, or gain further benefit from, longer-term, tailored support. This has important implications for decision-making about roll-out of DAFNEplus post-trial, and for development of future programmes seeking to bring about sustainable changes in self-management practices.
| Original language | English |
|---|---|
| Article number | e15371 |
| Number of pages | 14 |
| Journal | Diabetic Medicine |
| Early online date | 31 May 2024 |
| DOIs | |
| Publication status | E-pub ahead of print - 31 May 2024 |