Participants' experiences of attending a structured education course (DAFNEplus) informed by behavioural science

Julia Lawton; Paul M Chadwick; Nicole de Zoysa; Stephanie Stanton-Fay; Simon R Heller; David Rankin; DAFNEplus Study Group

doi:10.1111/dme.15309

Participants' experiences of attending a structured education course (DAFNEplus) informed by behavioural science

Diabet Med. 2024 Feb 15:e15309. doi: 10.1111/dme.15309. Online ahead of print.

Authors

Julia Lawton¹, Paul M Chadwick², Nicole de Zoysa³, Stephanie Stanton-Fay², Simon R Heller^{4

5}, David Rankin¹; DAFNEplus Study Group

Affiliations

¹ Usher Institute, Medical School, University of Edinburgh, Edinburgh, UK.
² UCL Centre for Behaviour Change, University College London, London, UK.
³ Diabetes Centre, King's College Hospital, London, UK.
⁴ Department of Diabetes and Endocrinology, Sheffield Teaching Hospitals NHS FT, Sheffield, UK.
⁵ Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK.

PMID: 38361333
DOI: 10.1111/dme.15309

Abstract

Aims: As part of a broader process evaluation, we explored participants' experiences of, and engagement with, the DAFNEplus programme's group-based structured education course. This course, which was informed by behavioural science, provided participants with education and instruction to use flexible intensive insulin therapy (FIIT) together with techniques to identify and address unhelpful cognitive and emotional influences on their type 1 diabetes self-management.

Methods: We interviewed n = 28 DAFNEplus participants. Data were analysed thematically and took account of previous work exploring individuals' experiences of standard DAFNE courses.

Results: As well as benefitting from the DAFNEplus course's skills-based training and educational curriculum, participants' accounts suggested they had experienced cognitive and emotional changes that had positively influenced their confidence and motivation to adopt and sustain the use of FIIT. These benefits were most keenly felt by those who reported negative emotional states and mind-sets pre-course which had made their diabetes self-management challenging. Participants' cognitive and emotional changes were enabled through techniques used during the course to normalise setbacks and imperfect diabetes self-management, capitalise upon group synergies and encourage the use of social support, including from healthcare professionals. Participants also highlighted motivational gains arising from being reassured that diabetes complications are not common or inevitable if a FIIT regimen is followed.

Conclusions: Our findings suggest that offering training in FIIT, in conjunction with behaviour change techniques that target unhelpful mindsets and emotional resilience, may be more effective in promoting diabetes self-management than offering education and skills training alone.

Keywords: behaviour change; qualitative research; self-management; structured education; type 1 diabetes; user experience.

Grants and funding

RP-PG-0514-20013/National Institute for Health Research (NIHR)