Development of a Supported Self-management Intervention for People With Severe Mental Illness and Type 2 Diabetes: Theory and Evidence-Based Co-design Approach
BackgroundType 2 diabetes is 2 to 3 times more common among people with severe mental illness (SMI). Self-management is crucial, with additional challenges faced by people with SMI. Therefore, it is essential that any diabetes self-management program for people with SMI addre...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2023-05-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2023/1/e43597 |
| _version_ | 1797734177367392256 |
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| author | Claire Carswell Peter A Coventry Jennifer V E Brown Sarah L Alderson Keith Double Simon Gilbody Richard I G Holt Rowena Jacobs Jennie Lister David Osborn David Shiers Najma Siddiqi Johanna Taylor Ian Kellar |
| author_facet | Claire Carswell Peter A Coventry Jennifer V E Brown Sarah L Alderson Keith Double Simon Gilbody Richard I G Holt Rowena Jacobs Jennie Lister David Osborn David Shiers Najma Siddiqi Johanna Taylor Ian Kellar |
| author_sort | Claire Carswell |
| collection | DOAJ |
| description |
BackgroundType 2 diabetes is 2 to 3 times more common among people with severe mental illness (SMI). Self-management is crucial, with additional challenges faced by people with SMI. Therefore, it is essential that any diabetes self-management program for people with SMI addresses the unique needs of people living with both conditions and the inequalities they experience within health care services.
ObjectiveWe combined theory, empirical evidence, and co-design approaches to develop a type 2 diabetes self-management intervention for people with SMI.
MethodsThe development process encompassed 4 steps: step 1 involved prioritizing the mechanisms of action (MoAs) and behavior change techniques (BCTs) for the intervention. Using findings from primary qualitative research and systematic reviews, we selected candidate MoAs to target in the intervention and candidate BCTs to use. Expert stakeholders then ranked these MoAs and BCTs using a 2-phase survey. The average scores were used to generate a prioritized list of MoAs and BCTs. During step 2, we presented the survey results to an expert consensus workshop to seek expert agreement with the definitive list of MoAs and BCTs for the intervention and identify potential modes of delivery. Step 3 involved the development of trigger films using the evidence from steps 1 and 2. We used animations to present the experiences of people with SMI managing diabetes. These films were used in step 4, where we used a stakeholder co-design approach. This involved a series of structured workshops, where the co-design activities were informed by theory and evidence.
ResultsUpon the completion of the 4-step process, we developed the DIAMONDS (diabetes and mental illness, improving outcomes and self-management) intervention. It is a tailored self-management intervention based on the synthesis of the outputs from the co-design process. The intervention incorporates a digital app, a paper-based workbook, and one-to-one coaching designed to meet the needs of people with SMI and coexisting type 2 diabetes.
ConclusionsThe intervention development work was underpinned by the MoA theoretical framework and incorporated systematic reviews, primary qualitative research, expert stakeholder surveys, and evidence generated during co-design workshops. The intervention will now be tested for feasibility before undergoing a definitive evaluation in a pragmatic randomized controlled trial. |
| first_indexed | 2024-03-12T12:40:31Z |
| format | Article |
| id | doaj.art-8f3296bea9c14a97a098b21afe0a5c78 |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-12T12:40:31Z |
| publishDate | 2023-05-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-8f3296bea9c14a97a098b21afe0a5c782023-08-28T23:54:32ZengJMIR PublicationsJournal of Medical Internet Research1438-88712023-05-0125e4359710.2196/43597Development of a Supported Self-management Intervention for People With Severe Mental Illness and Type 2 Diabetes: Theory and Evidence-Based Co-design ApproachClaire Carswellhttps://orcid.org/0000-0003-3781-3286Peter A Coventryhttps://orcid.org/0000-0003-0625-3829Jennifer V E Brownhttps://orcid.org/0000-0003-0943-5177Sarah L Aldersonhttps://orcid.org/0000-0002-5418-0495Keith Doublehttps://orcid.org/0009-0008-5728-7424Simon Gilbodyhttps://orcid.org/0000-0002-8236-6983Richard I G Holthttps://orcid.org/0000-0001-8911-6744Rowena Jacobshttps://orcid.org/0000-0001-5225-6321Jennie Listerhttps://orcid.org/0000-0002-2911-8331David Osbornhttps://orcid.org/0000-0003-2519-1539David Shiershttps://orcid.org/0000-0003-2531-5837Najma Siddiqihttps://orcid.org/0000-0003-1794-2152Johanna Taylorhttps://orcid.org/0000-0001-5898-0900Ian Kellarhttps://orcid.org/0000-0003-1608-5216 BackgroundType 2 diabetes is 2 to 3 times more common among people with severe mental illness (SMI). Self-management is crucial, with additional challenges faced by people with SMI. Therefore, it is essential that any diabetes self-management program for people with SMI addresses the unique needs of people living with both conditions and the inequalities they experience within health care services. ObjectiveWe combined theory, empirical evidence, and co-design approaches to develop a type 2 diabetes self-management intervention for people with SMI. MethodsThe development process encompassed 4 steps: step 1 involved prioritizing the mechanisms of action (MoAs) and behavior change techniques (BCTs) for the intervention. Using findings from primary qualitative research and systematic reviews, we selected candidate MoAs to target in the intervention and candidate BCTs to use. Expert stakeholders then ranked these MoAs and BCTs using a 2-phase survey. The average scores were used to generate a prioritized list of MoAs and BCTs. During step 2, we presented the survey results to an expert consensus workshop to seek expert agreement with the definitive list of MoAs and BCTs for the intervention and identify potential modes of delivery. Step 3 involved the development of trigger films using the evidence from steps 1 and 2. We used animations to present the experiences of people with SMI managing diabetes. These films were used in step 4, where we used a stakeholder co-design approach. This involved a series of structured workshops, where the co-design activities were informed by theory and evidence. ResultsUpon the completion of the 4-step process, we developed the DIAMONDS (diabetes and mental illness, improving outcomes and self-management) intervention. It is a tailored self-management intervention based on the synthesis of the outputs from the co-design process. The intervention incorporates a digital app, a paper-based workbook, and one-to-one coaching designed to meet the needs of people with SMI and coexisting type 2 diabetes. ConclusionsThe intervention development work was underpinned by the MoA theoretical framework and incorporated systematic reviews, primary qualitative research, expert stakeholder surveys, and evidence generated during co-design workshops. The intervention will now be tested for feasibility before undergoing a definitive evaluation in a pragmatic randomized controlled trial.https://www.jmir.org/2023/1/e43597 |
| spellingShingle | Claire Carswell Peter A Coventry Jennifer V E Brown Sarah L Alderson Keith Double Simon Gilbody Richard I G Holt Rowena Jacobs Jennie Lister David Osborn David Shiers Najma Siddiqi Johanna Taylor Ian Kellar Development of a Supported Self-management Intervention for People With Severe Mental Illness and Type 2 Diabetes: Theory and Evidence-Based Co-design Approach Journal of Medical Internet Research |
| title | Development of a Supported Self-management Intervention for People With Severe Mental Illness and Type 2 Diabetes: Theory and Evidence-Based Co-design Approach |
| title_full | Development of a Supported Self-management Intervention for People With Severe Mental Illness and Type 2 Diabetes: Theory and Evidence-Based Co-design Approach |
| title_fullStr | Development of a Supported Self-management Intervention for People With Severe Mental Illness and Type 2 Diabetes: Theory and Evidence-Based Co-design Approach |
| title_full_unstemmed | Development of a Supported Self-management Intervention for People With Severe Mental Illness and Type 2 Diabetes: Theory and Evidence-Based Co-design Approach |
| title_short | Development of a Supported Self-management Intervention for People With Severe Mental Illness and Type 2 Diabetes: Theory and Evidence-Based Co-design Approach |
| title_sort | development of a supported self management intervention for people with severe mental illness and type 2 diabetes theory and evidence based co design approach |
| url | https://www.jmir.org/2023/1/e43597 |
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