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Abstract
Objective Intensive lifestyle interventions reduce the risk of type 2 diabetes in populations at highest risk, but staffing levels are usually unable to meet the challenge of delivering effective prevention strategies to a very large at-risk population. Training volunteers with existing type 2 diabetes to support healthcare professionals deliver lifestyle interventions is an attractive option.
Methods We identified 141 973 people at highest risk of diabetes in the East of England, screened 12 778, and randomized 1764 into a suite of type 2 diabetes prevention and screen detected type 2 diabetes management trials. A key element of the program tested the value of volunteers with type 2 diabetes, trained to act as diabetes prevention mentors (DPM) when added to an intervention arm delivered by healthcare professionals trained to support participant lifestyle change.
Results We invited 9951 people with type 2 diabetes to become DPM and 427 responded (4.3%). Of these, 356 (83.3%) were interviewed by phone, and of these 131 (36.8%) were interviewed in person. We then appointed 104 of these 131 interviewed applicants (79%) to the role (mean age 62 years, 55% (n=57) male). All DPMs volunteered for a total of 2895 months, and made 6879 telephone calls to 461 randomized participants. Seventy-six (73%) DPMs volunteered for at least 6 months and 66 (73%) for at least 1 year.
Discussion Individuals with type 2 diabetes can be recruited, trained and retained as DPM in large numbers to support a group-based diabetes prevention program delivered by healthcare professionals. This volunteer model is low cost, and accesses the large type 2 diabetes population that shares a lifestyle experience with the target population. This is an attractive model for supporting diabetes prevention efforts.
- type 2 diabetes prevention
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Footnotes
Collaborators NDPS Group: Sara Auckland, Max Bachmann, Garry Barton, Ketan Dhatariya, Colin Greaves, Martin Hadley-Brown, Amanda Howe, Lisa Irvine, Garry John, Rebecca Usher, David Rea, Jane Smith, Jeremy Turner, Tara Wallace.
Contributors NJG led the recruitment, training and supervision of DPM, researched data, and led the writing of the manuscript. MP as program manager reviewed the manuscript and contributed with recruitment. KF contributed to retention and supervision of DPM. SA reviewed the manuscript and contributed to recruitment. MS as chief investigator and guarantor reviewed and edited the manuscript. All authors read and approved the final manuscript.
Funding The study was funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research (Reference No: RP-PG-0109-10013). Additional funding came from the NIHR Clinical Research Network (Eastern) and the Norfolk and Norwich University Hospital NHS Trust.
Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The funding source(s) had no role in data collection, writing or any version of this manuscript.
Competing interests None declared.
Patient consent for publication Obtained.
Ethics approval The study was approved by East of England (REC 2011).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.