The Challenge
The number of people diagnosed with Type 2 diabetes is increasing worldwide. Unfortunately, people from ethnic minority backgrounds are at greater risk – up to five times more likely to develop diabetes than white people. They develop diabetes at a younger age, and they are more susceptible to developing long-term complications associated with diabetes. According to the census 2021, Black and Asian ethnic groups had more than double the prevalence of pre-diabetes (22%) compared with White, Mixed and Other ethnic groups (10%).
The long-term complications of diabetes are harmful, life limiting and costly to treat. To detect and treat these complications in the early stages, the NHS has nine ways of testing and checking people with diabetes. People from ethnic minority backgrounds are particularly unlikely to get these checks. Finding new ways of improving their access to these checks and encouraging participation would allow early treatment and detection of long-term complications such as blindness, amputations and kidney disease.
CYMELL is a collaborative community based education programme to reduce inequalities in the uptake of diabetes follow-on checks amongst minority ethnic people in Wales.
Project Chief Investigator Dr Rose Stewart and HEI lead Dr Ashra Khanom and team are developing community-based education and prevention programmes for diabetes, targeting people from ethnic minority backgrounds. Initially a scoping review of the existing literature was carried out around the research area. The team then ran workshops with people from ethnic minorities with lived experience of diabetes as well as service providers, ethnic community leaders and workers, to co-design and develop the intervention. These workshops allowed the team to define key elements of an effective community-based intervention to improve accessibility and understanding of diabetes follow-on tests and identify important outcomes.
DF-CARW: Diabetes Follow-on Checks Awareness Raising Workshops
A short, animated video was developed to support the delivery of DF-CARW. The workshops and support materials have been piloted in Swansea and will now be trialled in Cardiff, Wrexham and Colwyn Bay, which are areas with a higher proportion of people from ethnic minority background than the Welsh average.
Participants taking part in the DF-CARW intervention are offered information on how to access follow on care through their GP and to self-manage their diabetes for better health outcomes. They will have the opportunity to discuss eye screening, foot checks and kidney tests with a specialist diabetes nurse. Participants will also have the option to get their feet examined by a podiatrist and explore the eye examination equipment. The project team will gather data before and after the intervention from the participants to guide the planning of a future full trial.
The project has received funding from Health and Care Research Wales and is sponsored by Betsi Cadwaladr University Health Board (BCUHB).
The Impact
The aim of the ongoing project is to co-design and pilot a community-based education program to be delivered by specialist diabetes nurses, community leaders and support workers to improve diabetes health literacy and accessibility and take-up of diabetes follow on checks amongst people from ethnic minority backgrounds. Ultimately the project’s purpose is to improve the lives of ethnic minority people in Wales living with diabetes and to increase the uptake of follow-on checks among underserved populations.
The team includes; Chief Investigator: Dr Rose Stewart BCUHB, HEI Principal Co-investigator: Dr Ashra Khanom, Study Managers: Dr Diana Beljaars and Dr Gargi Naha, Co-investigators: Dr Rebecca Louise Thomas, Dr Alison Porter, Dr Llinos Haf Spencer (University of South Wales), Dr Nicola O’Brien (Northumbria University), Professor Sian Rees, Mrs Rafat Arshad-Roberts, BCUHB, Dr Shadan Roghani, Neath Port Talbot CVS, and Professor Alan Watkins. Public Members: Mrs Thanuja Hettiarachchi and Gayan Kodagodage Administration: Daniel Holohan. Third Sector Partners: Leanne Jenkins (Diabetes Cymru), Sujatha Thaladi (Mentor Ring), Helal Uddin (EYST), Alice Botsyeo-Amedor (BAWSO)
