A qualitative study exploring the barriers to attending structured education programmes among adults with type 2 diabetes
A qualitative study exploring the barriers to attending structured education programmes among adults with type 2 diabetes
Background: Diabetes self-management education, a universally recommended component of diabetes care, aims to support self-management in people with type 2 diabetes. However, attendance is low (approx. 10%). Previous research investigating the reasons for low attendance have not yet linked findings to theory, making it difficult to translate findings into practice. This study explores why some adults with type 2 diabetes do not attend diabetes self-management education and considers how services can be adapted accordingly, using Andersen’s Behavioural Model of Health Service Utilisation as a framework. Methods: A cross-sectional semi-structured qualitative interview study was carried out. Semi-structured interviews were conducted by telephone with 14 adults with type 2 diabetes who had verbally declined their invitation to attend diabetes self-management education in Bath and North East Somerset, UK, within the last 2 years. Data were analysed using inductive thematic analysis before mapping the themes onto the factors of Andersen’s Behavioural Model. Results: Two main themes were identified: ‘perceived need’ and ‘practical barriers’. The former theme explored participants’ tendency to decline diabetes education when they perceived they did not need the programme. This perception tended to arise from participants’ high self-efficacy to manage their type 2 diabetes, the low priority they attributed to their condition and limited knowledge about the programme. The latter theme, ‘practical barriers’, explored the notion that some participants wanted to attend but were unable to due to other commitments and/or transportation issues in getting to the venue. Conclusions: All sub-themes resonated with one or more factors of Andersen’s Behavioural Model indicating that the model may help to elucidate attendance barriers and ways to improve services. To fully understand low attendance to diabetes education, the complex and individualised reasons for non-attendance must be recognised and a person-centred approach should be taken to understand people’s experience, needs and capabilities.
Adult, Diabetes mellitus, Patient non-attendance, Self-management, Type 2 diabetes
Coningsby, Imogen
bf66fcdf-086f-40bd-b226-5f8b1dab4efa
Dack, Charlotte
d3b4f40f-0c5d-4117-9aaa-e500976d4af5
Ainsworth, Ben
b02d78c3-aa8b-462d-a534-31f1bf164f81
30 April 2022
Coningsby, Imogen
bf66fcdf-086f-40bd-b226-5f8b1dab4efa
Dack, Charlotte
d3b4f40f-0c5d-4117-9aaa-e500976d4af5
Ainsworth, Ben
b02d78c3-aa8b-462d-a534-31f1bf164f81
Coningsby, Imogen, Dack, Charlotte and Ainsworth, Ben
(2022)
A qualitative study exploring the barriers to attending structured education programmes among adults with type 2 diabetes.
BMC Health Services Research, 22 (1), [584].
(doi:10.1186/s12913-022-07980-w).
Abstract
Background: Diabetes self-management education, a universally recommended component of diabetes care, aims to support self-management in people with type 2 diabetes. However, attendance is low (approx. 10%). Previous research investigating the reasons for low attendance have not yet linked findings to theory, making it difficult to translate findings into practice. This study explores why some adults with type 2 diabetes do not attend diabetes self-management education and considers how services can be adapted accordingly, using Andersen’s Behavioural Model of Health Service Utilisation as a framework. Methods: A cross-sectional semi-structured qualitative interview study was carried out. Semi-structured interviews were conducted by telephone with 14 adults with type 2 diabetes who had verbally declined their invitation to attend diabetes self-management education in Bath and North East Somerset, UK, within the last 2 years. Data were analysed using inductive thematic analysis before mapping the themes onto the factors of Andersen’s Behavioural Model. Results: Two main themes were identified: ‘perceived need’ and ‘practical barriers’. The former theme explored participants’ tendency to decline diabetes education when they perceived they did not need the programme. This perception tended to arise from participants’ high self-efficacy to manage their type 2 diabetes, the low priority they attributed to their condition and limited knowledge about the programme. The latter theme, ‘practical barriers’, explored the notion that some participants wanted to attend but were unable to due to other commitments and/or transportation issues in getting to the venue. Conclusions: All sub-themes resonated with one or more factors of Andersen’s Behavioural Model indicating that the model may help to elucidate attendance barriers and ways to improve services. To fully understand low attendance to diabetes education, the complex and individualised reasons for non-attendance must be recognised and a person-centred approach should be taken to understand people’s experience, needs and capabilities.
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s12913-022-07980-w
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More information
e-pub ahead of print date: 30 April 2022
Published date: 30 April 2022
Additional Information:
Funding Information:
With thanks to Sarah Button and the team at the Wellbeing Service, Virgin Care Limited (now called HCRG Care Group) for their support throughout the project.
Publisher Copyright:
© 2022, The Author(s).
Keywords:
Adult, Diabetes mellitus, Patient non-attendance, Self-management, Type 2 diabetes
Identifiers
Local EPrints ID: 470450
URI: http://eprints.soton.ac.uk/id/eprint/470450
ISSN: 1472-6963
PURE UUID: 5ad39326-8606-4f33-acc1-474b6d5c506e
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Date deposited: 11 Oct 2022 16:36
Last modified: 17 Mar 2024 03:19
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Contributors
Author:
Imogen Coningsby
Author:
Charlotte Dack
Author:
Ben Ainsworth
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