Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) programme for African and Caribbean communities: Feasibility and acceptability of a remote education programme and lessons learnt

Aim: To assess the feasibility and acceptability of remote videoconferencing delivery of the Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) programme during the covid-19 pandemic. Method: Stage one: a patient telephone survey, assessed likely engagement with remote delivery, alongside provider and commissioner discussions to establish affordability. Stage two: development of a specification and delivery model for HEAL-D remote delivery, considering referral pathways and platform functionality e.g. delivery of participatory activities (e.g. exercise classes), and fostering of peer support. Stage three: pilot delivery of four courses to 23 patients across three boroughs and evaluation, comprising a pre/post-course questionnaire. Results: Eleven of 16 patients said they would attend a remote programme, one needed support and five had no internet/equipment. Of 80 funded places, only 27 referrals were received;85% (n = 23) accepted a place and four courses were delivered. 70% (n = 16) completed the course (attended ≥six of seven sessions). Service provider barriers to referring included the referral process not embedding within standard referral pathways and pressures associated with covid-19 and flu vaccinations. Patients evaluated the course highly;all agreed/strongly agreed that, as a result of the course, they learned practical skills and feel more motivated and supported to manage their diabetes. Conclusions: Remote delivery of culturally tailored diabetes education is acceptable to patients, however;a better understanding of digital exclusion is needed and ease of referral pathways is pivotal for service providers. More work is required to establish if the on-line programme elements can replicate the engagement and clinical improvements of face-to- face delivery.