A real-world mixed methods study of the feasibility, acceptability and impact of an online structured education programme for type 2 diabetes

Background: Structured education for people with type 2 diabetes improves outcomes, but uptake is low globally. In the UK in 2016, only 8.3% of people who were referred to education programmes attended. We have developed an online structured education programme called HeLP-Diabetes: Starting Out; (HDSO), as an alternative to face-to-face courses. An online programme gives people more options for accessing structured education and may help improve overall uptake. // Objectives: The aim was to explore the feasibility and acceptability of delivering an online structured education programme (called HeLP-Diabetes: Starting Out) in routine primary healthcare and its potential impact on self-efficacy and diabetes-related distress. // Methods: HeLP-Diabetes: Starting Out was delivered as part of routine diabetes services in primary healthcare in the United Kingdom, having been commissioned by local Clinical Commissioning Groups. Quantitative data were collected on uptake, use of the programme, demographic characteristics, and self-reported self-efficacy and diabetes-related distress. A sub-sample of people with type 2 diabetes and healthcare professionals were interviewed about acceptability of the programme. // Results: It was feasible to deliver the programme, but completion rates were low: of 791 people with type 2 diabetes registered only 74 (9%) completed it. Completers improved their self-efficacy (change in median score 2.5, p=0.001) and diabetes-related distress (change in median score 6.0, p=0.001). Interview data suggested that the course was acceptable, and that uptake and completion may be related to non-prioritization of structured education. // Conclusions: The study provides evidence of the feasibility and acceptability of online structured education. However, uptake and completion rates were low, limiting potential population impact. Further research is needed to improve completion rates, and to determine the relative effectiveness of online versus face-to-face education.