Summary

Results

The team built its understanding of how South Asian communities relate to self-management and presented our learning to a wide audience through posters, articles, reports and presentations. It delivered four healthy cooking demonstrations and successfully piloted two walking groups.

New self-management resources in South Asian languages proved popular. Guided self-management support was provided to 120 group participants, reaching over 3,000 people with information in English, Urdu, Punjabi and Hindi.

The ream used a range of participatory evaluation techniques and tools to gain insight into what individuals with diabetes regard as barriers to, and facilitators of, self-management. 29 volunteers were recruited and trained to raise awareness and give accurate information within their communities about diabetes and the importance of self-management.

Challenge

People of South Asian origin in the UK are up to six times more likely to develop type 2 diabetes. They can develop it when 10 years younger than members of the white population, and are at higher risk of developing diabetes-related complications.

Did Not Attend (DNA) rates are significantly higher among this population due to a wide variety of issues surrounding access to information and services. Barriers include language, misconceptions about diabetes and poor knowledge of treatments.

This project was the first of its kind for Diabetes Scotland, initially engaging with people over the age of 45 living in Glasgow. This group has a high prevalence of diabetes, and includes many carers for diabetes patients.

Objectives

In 2012 and 2013 the project worked towards several outcomes. It hoped to learn how South Asian communities relate to the concept of self-management, to understand how to support the target group in its self-management, and to increase the availability of resources.

The project also aimed to help improve the target group’s understanding of diabetes and how to look after themselves on a daily basis. Other goals included increasing trust within the communities for the work of Diabetes UK Scotland, improving the charity’s ability to support people from South Asian communities living with diabetes, and building partnerships with relevant public and voluntary organisations to deliver joint health promotion and prevention activities. 

Solution

The first year focused on consulting with the NHS and community organisations, identifying participants, recruiting volunteers and setting up self-management support groups.

In its second year, the project widened its reach, consulting more stakeholders. The consultations aimed to understand what those living with diabetes need to self-manage, and to use this learning to design project activities. We then designed the framework for our community engagement methodology.

This focused on approaching communities, not directly but by involvement in festivals and events, and building trust by clearly communicating our role and commitment at the onset. The framework also involved communicating effectively, with an emphasis on one-to-one, face-to-face, interaction, and empowering volunteers, by supporting them to take healthy lifestyle messages into their communities.

Learnings

The two year project concluded that people feel the need to have a support network outside the NHS to help them manage the day-to-day challenges of living with diabetes.

We found that different approaches are needed to identify ways of communicating with South Asian people, and that information needs to be followed up with practical advice. Peer support networks need to be built to sustain lifestyle changes.

We also learnt that in order to promote self-management of diabetes, we need to focus on several elements. These include: helping make sense of the condition; providing appropriate messages, understanding the role of healthcare professionals; working with other organisations; and creating the right environment for working with South Asian communities.

Evaluation

The project has had multiple impacts, on the communities it works with, the organisation and on stakeholders. Many group participants are maintaining healthy lifestyle changes, while some groups have grown into peer support teams.

Diabetes self-management is now seen as relevant to South Asian communities, with Diabetes Scotland increasingly accepted as a trusted provider of information and support.

Organisations, including NHS services working with South Asian communities, see Diabetes Scotland as a provider of culturally appropriate support.