Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) programme for African and Caribbean communities: Feasibility and acceptability of a remote education programme and lessons learnt

ABSTRACT

Aim: To assess the feasibility and acceptability of remote videoconferencing delivery of the Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) programme during the covid-19 pandemic. Method: Stage one a patient telephone survey, assessed likely engagement with remote delivery, alongside provider and commissioner discussions to establish affordability. Stage two development of a specification and delivery model for HEAL-D remote delivery, considering referral pathways and platform functionality e.g. delivery of participatory activities (e.g. exercise classes), and fostering of peer support. Stage three pilot delivery of four courses to 23 patients across three boroughs and evaluation, comprising a pre/post-course questionnaire. Results: Eleven of 16 patients said they would attend a remote programme, one needed support and five had no internet/equipment. Of 80 funded places, only 27 referrals were received;85% (n = 23) accepted a place and four courses were delivered. 70% (n = 16) completed the course (attended ≥six of seven sessions). Service provider barriers to referring included the referral process not embedding within standard referral pathways and pressures associated with covid-19 and flu vaccinations. Patients evaluated the course highly;all agreed/strongly agreed that, as a result of the course, they learned practical skills and feel more motivated and supported to manage their diabetes. Conclusions: Remote delivery of culturally tailored diabetes education is acceptable to patients, however;a better understanding of digital exclusion is needed and ease of referral pathways is pivotal for service providers. More work is required to establish if the on-line programme elements can replicate the engagement and clinical improvements of face-to- face delivery.