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Title: The Barriers to Uptake of Diabetes Education (BUDiE) Study
Author: Harris, Sophie Myra
ISNI:       0000 0004 6423 1537
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2017
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Structured education in flexible intensive insulin therapy not only transfers skills from healthcare professional to person with type 1 diabetes to provide skills in dose adjustment, but has psychological benefit likely due to the peer support element. National and local uptake of structured education is poor. This mixed methods study used three phases to examine reasons for low uptake in two south London boroughs. The first phase was quantitative. It used an existing local diabetes database to identify demographics and service-use differences between two groups (attenders and non-attenders) from 2006 – 2012. It illustrated demographics associated with social determinants of health, such as gender and social deprivation, influence attendance. Phase two used both qualitative and quantitative methods; survey and interviews. A cross-sectional survey of both people with type 1 diabetes and their healthcare professionals further explored demographic and service-use differences as well as reasons for non-attendance. Semi-structured interviews with non-attenders used thematic analysis to identify four typologies; ‘go-getters’, ‘not-yetters’, ‘trodden downers’ and ‘diabetes downers’. These were based on influential characteristics such as numerical and psychological capability and internal or external locus of control. Phase three used focus groups with a representative sample of healthcare professionals that input into the entire diabetes care pathway, from commissioner through to person with diabetes, to discuss findings from earlier phases and reach solutions or recommendations for future interventions; such as healthcare professional training in motivational interviewing, psychological support, improved marketing and additional support for individuals with low numeracy. The BUDiE study identified differences in demographic variables between attenders and non-attenders at structured education, the most influential being educational attainment. Four types of non-attenders were identified; go-getters, not yetters, trodden downers and diabetes downers. Integration of all three phases of the study allowed quantification of each of these types, with recommendations to improve uptake for each.
Supervisor: Amiel, Stephanie Anne ; Mulnier, Henrietta Elizabeth Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available