Summary
Carbs & Cals specialises in books and apps for diabetes, weight loss, portion control, and healthy eating. The method of using thousands of food photos to count carbohydrates (carbs) and calories is both new and simple. It has been nationally recognised as the leading carb-counting resource for Type 1 diabetes for nine years running. Since winning the QiC Award in 2014, Carbs & Cals has published ten additional books, including resources for Type 2, weight loss, gestational, plus black and minority ethnic (BAME) communities. The self-funding project has gone from strength to strength, working with a variety of partners and research projects to help an ever-growing number of people self-manage their diabetes and other conditions. It is a low-cost and accessible resource that is being used throughout the country and beyond.
Results
Since the last QiC award win in 2014, the following innovations have been introduced: 5:2 Diet Photos book published; Smoothies, Salads & Soups published; new logo, branding and style; values updated in all resources; Very Low Calorie published and later translated to German; iOS app updated to new style; Gestational Diabetes published; Carb Portion List booklet made for DAFNE; World Foods published (and later in German). Resources are developed based on the requirements of patients and HCPs. For example, in 2016 the Carb & Calorie Counter 6th edition used several thousand reviews and feedback on previous version to make the book as easy to use and effective as possible, based on real-world user requirements. For new resources, such as World Foods, people with diabetes provided input at every step, including food diaries from BAME communities, online surveys to test designs, and commenting on a test version of the book. The number of books printed rises each year. In 2018, three times as many books were printed than in 2010 (when the first book was launched) and 50% more than in 2014, when Carbs & Cals last won a QiC Award. The number of Amazon reviews has increased 10-fold since 2014 (from 500 to over 5,000). Free flyers are requested every week across the UK, showing that the books are being recommended by HCPs from Aberdeen to Margate to Cornwall. There has also been a steady increase in social media reach (a recent Easter Egg post on Facebook reached 53,000 people organically, with 6,500 engagements and 270 shares). There is a loyal fanbase of 16,000 people on the email mailing list, with excellent engagement rates.
Dissemination and Sustainability
In the nine years since Carbs & Cals was established, 15 books have been developed. Products have been continually improved to make them as effective as possible. Knowledge, experience, processes and a team of regular freelancers ensure resources are developed more quickly than most NHS projects. The project’s founders and managers, Cheyette and Yello Balolia (Entrepreneur), remain committed to the project. There is still much scope to use existing content and expand resources to help more people with diabetes in the UK and beyond. The project is financially self-sustaining and generates enough funds to create further resources on an ongoing basis. Books can be used in clinic, on structured education courses, and by those with diabetes at home. Resources are designed to be simple, accessible and used flexibly in a variety of healthcare settings. Originally aimed at Type 1, resources have since been extended to Type 2, gestational (GD), weight loss, healthy eating and, most recently, Type 2 in BAME communities. Books have been developed for other countries: Portugal (in association with APDP) and books have been licensed in the Netherlands and Germany. The app now has food databases for the UK, US, Germany, Austria, Italy and Portugal. HCPs across the country have been encouraged to use books in clinic (e.g. a free CARB & CALORIE COUNTER was sent to every diabetes centre in the UK). Diabetes UK (DUK) supports and sells the books. Work is also undertaken with structured education programmes (e.g. producing 18,000 CARB PORTION LIST booklets for DAFNE) and partnerships have been formed with companies like Roche, which distributes thousands of free books each year with meters. Further dissemination has been through having a stand at the DUK Conference and multiple articles and reviews in healthcare magazines and the mainstream media. There is free content (50 PDFs) on the website and social media reaches the public and HCPs.
Method
Over nine years, researching and producing books has been refined to ensure that each resource fills a gap in health education and self-management. The project’s co-founder and manager, Chris Cheyette (Diabetes Specialist Dietitian) works in the NHS (King’s College Hospital), delivers the Dose Adjustment for Normal Eating (DAFNE) course, is a British Dietetic Association (BDA) member and speaks at conferences regularly. This interaction with patients and HCPs allows Carbs & Cals to keep up to date with latest evidence and gaps in education resources, quickly responding to opportunities. A clear demand is identified before resources are created, gaining interest from organisations such as BDA, Diabetes UK and pharma. Users and HCPs are involved during the planning process and resources are researched by credible experts in each field. Resources are produced efficiently, making use of budget and minimising time to launch. It is a self-funded organisation (via book sales), meaning no delays sourcing, or waiting for, funding. Regular freelancers are used to produce books quickly. The books are thoroughly checked and tested before printing. All information meets nationally-recognised guidelines and nutritional information is accurate.
