Embedding Study

Increasing uptake of effective self-management education programmes for type 2 diabetes in multi-ethnic primary care settings.

Study title

Background

Type 2 Diabetes Mellitus (T2DM) is one of the fastest growing health challenges of the 21st century, with the number of adults living with diabetes having more than tripled over the past 20 years. Diabetes structured education (DSE) programmes have been proven to help people with diabetes to manage their condition and improve their knowledge, skills and outcomes, and yet uptake of DSEs is very low.

Study Aims

The aim of the Embedding study was to implement a specifically designed ‘Embedding Package’ to test whether it will increase attendance at Type 2 diabetes structured education (DSE). 

Study Summary

The Embedding Diabetes Education RCT is part of a 5-year National Institute for Health Research (NIHR) grant research project looking to increase attendance at DSE. The study was not about testing a particular diabetes education programme. In this RCT, previously identified enablers and solutions to barriers will be tested at scale and confirm the utility of the ‘Embedding Package’ across numerous DSE providers.

This package included a website toolkit containing information, strategies and tools that can be used at practice level to help improve patient attendance at DSE programmes by people with T2DM. Additionally an ‘embedder’ from the study team worked with the local education provider to develop an action plan for the whole locality. 

Study Progress 

The study was open at 61 GP practices and at 5 education provider sites across 10 CCGs in England. Recruitment of participants finished in February 2022. Intervention implementation, with key activities focused on addressing barriers and enablers to uptake at patient, HCP, and organisation levels to DSE programmes. The ethnographic sub-study was looking at the process of implementation and the fit of the intervention. The cost-effectiveness sub-study provided cost estimates of the implementation of the ‘Embedding Package’ together with an estimate of its overall value for money.

Funding and Sponsorship 

Funding Body: NIHR Programme Grant for Applied Research

Sponsor: University of Leicester

Study Publications

The impact of an intervention to increase uptake to structured self-management education for people with type 2 diabetes mellitus in primary care (the embedding package), compared to usual care, on glycaemic control: study protocol for a mixed methods study incorporating a wait-list cluster randomised controlled trial | BMC Family Practice 

https://www.ncbi.nlm.nih.gov/pubmed/31699046

Application of normalisation process theory in understanding implementation processes in primary care settings in the UK: a systematic review | BMC Family Practice, click here to access

Research Team

Principal Investigator: Professor Melanie Davies

Project Manager: Agnieszka Glab