Project Summary
People with type 2 diabetes (T2DM) commonly experience diabetes-related emotional distress, which is linked to poorer self-management and health outcomes. Support for emotional wellbeing is often unavailable or difficult to access, particularly for people from socioeconomically disadvantaged or ethnically minoritised communities—groups who are also at greater risk of digital exclusion.
This 18-month study aims to co-design and optimise a digital intervention to support emotional wellbeing in people with T2DM. The intervention will be adapted from an existing evidence-based digital programme (Healthy Paths) and will be tailored for accessibility, cultural relevance, and equity. The project includes a scoping review, qualitative research, and co-design activities with people with lived experience and healthcare professionals.
Aims
The overall aim is to co-develop a culturally relevant, acceptable, and accessible digital intervention that addresses emotional wellbeing in people with type 2 diabetes, with particular attention to groups at risk of health inequalities and digital exclusion.
Specific objectives:
- To synthesise evidence on digital emotional wellbeing support for T2DM, with attention to equity and inclusion.
- To explore the views and experiences of people with T2DM and healthcare professionals about digital support for diabetes distress.
- To co-design and iteratively refine a prototype digital intervention using participatory methods.
- To develop a theory-informed implementation strategy for use in routine primary care.
Methods
The study comprises three integrated work packages:
- Scoping Review
A mixed-methods review of existing digital interventions for diabetes distress and emotional wellbeing, with a focus on identifying approaches that promote inclusion and accessibility. - Qualitative Interviews
In-depth interviews with:
- People with T2DM (particularly from ethnically diverse and socioeconomically disadvantaged backgrounds).
- Primary care professionals.
The focus will be on understanding support needs, barriers to digital engagement, and preferred features of a digital tool.
3. Co-Design and Think-Aloud Usability Testing
Co-design workshops with people with T2DM and healthcare professionals to:
- Adapt Healthy Paths for diabetes-specific emotional needs.
- Test and refine usability, cultural acceptability, and accessibility.
- Develop an accompanying implementation plan.
PPI (Patient and Public Involvement) is embedded throughout all phases.
Targets for Reducing Health Inequalities and Improving Mortality and Morbidity
This project directly targets populations at higher risk of both diabetes complications and poor access to psychological support—including people from ethnically minoritised groups and lower-income backgrounds.
How the project addresses inequalities:
- Prioritises inclusion of underserved groups in all stages (interviews, co-design).
- Focuses on adapting an intervention for accessibility and digital inclusion.
- Builds on partnerships with community organisations to ensure cultural relevance and reach.
Potential impacts:
- Improved emotional wellbeing and self-management among people with T2DM.
- Reduced risk of diabetes complications and long-term morbidity by addressing psychological barriers to care.
- A scalable, low-cost intervention that can be delivered via primary care—enhancing reach and equity.
- Foundations for broader implementation across digitally excluded communities in future phases.
QMUL Co-applicant: Dr Judith Edwards Dr Mel Ramasawmy Dr Ronaldo-Raul Szekely
Co-PI: Dr Charlotte Dack University of Bath