Testing an analogue game to promote peer support and person-centredness in education for people with type 2 diabetes: a realist evaluation

Aim To explore the outcomes of testing an analogue game to incorporate person-centredness and peer dialogues in group-based diabetes education targeting people with type 2 diabetes Design A quasi-experimental design inspired by realistic evaluation focusing on context, mechanisms and outcomes of the intervention Methods In March-July 2019, the game was tested among 76 people with type 2 diabetes and 17 healthcare professionals in 19 settings across nine Danish municipalities. Data consisted of audio recordings, individual and group interviews and questionnaires. Data were analysed using systematic text condensation and descriptive statistics. Results Outcomes of using the analogue game in diabetes education were: 1) a playful and relaxed atmosphere; 2) active engagement 3) reflections on diabetes-specific experiences; 4) structured and focused dialogues; 5) healthcare professionals gaining insight into the preferences and needs of participants; and 6) healthcare professionals experiencing peer dialogue as important to incorporate into education. Questionnaire responses showed that 92% of people with type 2 diabetes and 94% of healthcare professionals found that the game incorporated person-centredness and peer dialogues into diabetes education. Conclusion Implementing the analogue game as part of patient education facilitated peer support and person-centredness in a fun and playful way. Lack of time in diabetes education programmes and complicated game rules inhibited person-centeredness and peer dialogue.