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Hendrieckx C, Russell-Green S, Skinner T, Ng AH, Lee C, Barlow S, Davey A, Rogers C, Holmes-Truscott E, Speight J. Diabetes Research Matters: A Three-Round Priority-Setting Survey Consultation with Adults Living with Diabetes and Family Members in Australia. THE PATIENT 2024:10.1007/s40271-024-00688-5. [PMID: 38582797 DOI: 10.1007/s40271-024-00688-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE We aimed to identify the health and quality-of-life research priorities of Australians with diabetes or family members. METHODS Through an iterative, three-step, online survey process we (1) qualitatively generated research topics (long list) in response to one question "What research is needed to support people with diabetes to live a better life?"; (2) determined the most important research questions (short list); and (3) ranked research questions in order of importance (priorities). We aimed to recruit N = 800 participants, with approximate equal representation of diabetes type and family members. RESULTS Participants (N = 661) were adults (aged 18+ years) in Australia with a self-reporting diagnosis of diabetes (type 1, n = 302; type 2, n = 204; prior/current gestational, n = 58; less common types, n = 22, or a family member, n = 75). Retention rates for Surveys 2 and 3 were 47% (n = 295) and 50% (n = 316), respectively. From 1549 open-text responses, 25 topics and 125 research questions were identified thematically. Research priorities differed by cohort, resulting in specific lists developed and ranked by each cohort. The top-ranked research question for the type 1 diabetes cohort was "How can diabetes technology be improved …?" and for the type 2 diabetes cohort: "How can insulin resistance be reversed …?". One question was common to the final lists of all cohorts: "What are the causes or triggers of diabetes?" Within cohorts, the top priorities were perceived as being of similar importance. CONCLUSIONS The research priorities differ substantially by diabetes type and for family members. These findings should inform funding bodies and researchers, to align future research and its communication with community needs.
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Affiliation(s)
- Christel Hendrieckx
- School of Psychology, Deakin University, 1-11 Gheringhap Street, Geelong, VIC, 3220, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Sienna Russell-Green
- School of Psychology, Deakin University, 1-11 Gheringhap Street, Geelong, VIC, 3220, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Timothy Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, VIC, Australia
| | - Ashley H Ng
- Monash Partners Academic Health Science Centre, Melbourne, VIC, Australia
| | - Chris Lee
- National Aboriginal Community Controlled Health Organisation, Canberra, ACT, Australia
| | - Siobhan Barlow
- Diabetes Research Matters Steering Group, Melbourne, Australia
| | - Alan Davey
- Diabetes Research Matters Steering Group, Melbourne, Australia
| | - Caitlin Rogers
- Diabetes Research Matters Steering Group, Melbourne, Australia
| | - Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, 1-11 Gheringhap Street, Geelong, VIC, 3220, Australia.
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.
| | - Jane Speight
- School of Psychology, Deakin University, 1-11 Gheringhap Street, Geelong, VIC, 3220, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
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Speight J, Holmes-Truscott E, Garza M, Scibilia R, Wagner S, Kato A, Pedrero V, Deschênes S, Guzman SJ, Joiner KL, Liu S, Willaing I, Babbott KM, Cleal B, Dickinson JK, Halliday JA, Morrissey EC, Nefs G, O'Donnell S, Serlachius A, Winterdijk P, Alzubaidi H, Arifin B, Cambron-Kopco L, Santa Ana C, Davidsen E, de Groot M, de Wit M, Deroze P, Haack S, Holt RIG, Jensen W, Khunti K, Kragelund Nielsen K, Lathia T, Lee CJ, McNulty B, Naranjo D, Pearl RL, Prinjha S, Puhl RM, Sabidi A, Selvan C, Sethi J, Seyam M, Sturt J, Subramaniam M, Terkildsen Maindal H, Valentine V, Vallis M, Skinner TC. Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations. Lancet Diabetes Endocrinol 2024; 12:61-82. [PMID: 38128969 DOI: 10.1016/s2213-8587(23)00347-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
People with diabetes often encounter stigma (ie, negative social judgments, stereotypes, prejudice), which can adversely affect emotional, mental, and physical health; self-care, access to optimal health care; and social and professional opportunities. To accelerate an end to diabetes stigma and discrimination, an international multidisciplinary expert panel (n=51 members, from 18 countries) conducted rapid reviews and participated in a three-round Delphi survey process. We achieved consensus on 25 statements of evidence and 24 statements of recommendations. The consensus is that diabetes stigma is driven primarily by blame, perceptions of burden or sickness, invisibility, and fear or disgust. On average, four in five adults with diabetes experience diabetes stigma and one in five experience discrimination (ie, unfair and prejudicial treatment) due to diabetes, such as in health care, education, and employment. Diabetes stigma and discrimination are harmful, unacceptable, unethical, and counterproductive. Collective leadership is needed to proactively challenge, and bring an end to, diabetes stigma and discrimination. Consequently, we achieved unanimous consensus on a pledge to end diabetes stigma and discrimination.
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Affiliation(s)
- Jane Speight
- School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
| | - Elizabeth Holmes-Truscott
- School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | | | - Renza Scibilia
- Diabetogenic, Melbourne, VIC, Australia; JDRF International, New York, NY, USA
| | - Sabina Wagner
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Asuka Kato
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Victor Pedrero
- Faculty of Nursing, Universidad Andrés Bello, Santiago, Chile
| | - Sonya Deschênes
- School of Psychology, University College Dublin, Dublin, Ireland
| | | | - Kevin L Joiner
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Shengxin Liu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Ingrid Willaing
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark; Institute of Public Health, Department of Health Services Research, University of Copenhagen, Copenhagen, Denmark
| | - Katie M Babbott
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Bryan Cleal
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Jane K Dickinson
- Department of Health Studies & Applied Educational Psychology, Teachers College Columbia University, New York, NY, USA
| | - Jennifer A Halliday
- School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Eimear C Morrissey
- Health Behavior Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Giesje Nefs
- Department of Medical Psychology, Radboudumc, Nijmegen, Netherlands; Center of Research on Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands; Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, Netherlands
| | - Shane O'Donnell
- Birmingham Law School, University of Birmingham, Birmingham, UK
| | - Anna Serlachius
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Per Winterdijk
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, Netherlands
| | - Hamzah Alzubaidi
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Bustanul Arifin
- Faculty of Pharmacy, Universitas Hasanuddin, Makassar, Indonesia
| | | | | | - Emma Davidsen
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Mary de Groot
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Maartje de Wit
- Medical Psychology, Amsterdam Public Health, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | | | - Richard I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Kamlesh Khunti
- Leicester Diabetes Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Karoline Kragelund Nielsen
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Tejal Lathia
- Department of Endocrinology, Apollo Hospitals, Navi Mumbai, India
| | | | | | - Diana Naranjo
- Department of Pediatrics, Division of Endocrinology, Stanford School of Medicine, Palo Alto, CA, USA
| | - Rebecca L Pearl
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Suman Prinjha
- Leicester Diabetes Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Rebecca M Puhl
- Department of Human Development & Family Sciences, College of Liberal Arts & Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Chitra Selvan
- Department of Endocrinology, Ramaiah Medical College, Bengaluru, India
| | - Jazz Sethi
- The Diabesties Foundation, Ahmedabad, India
| | - Mohammed Seyam
- Faculty of Medicine, Al-Quds University, Abu Dis, Palestine
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Mythily Subramaniam
- Institute of Mental Health Singapore, Singapore; Saw Swee Hock School of Public Health, National University Singapore, Singapore
| | - Helle Terkildsen Maindal
- Department of Prevention, Health Promotions & Community Care, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Copenhagen, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | - Timothy C Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia; La Trobe Rural Health School, La Trobe University, Flora Hill, VIC, Australia; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Kehlenbrink S, Jobanputra K, Reddy A, Boulle P, Gomber A, Nugent R, Varma V, Nakayama AT, Ellman T. Diabetes Care in Humanitarian Settings. Endocrinol Metab Clin North Am 2023; 52:603-615. [PMID: 37865476 DOI: 10.1016/j.ecl.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Despite the increasing prevalence of diabetes in populations experiencing humanitarian crisis, along with evidence that people living with diabetes are at higher risk for poor outcomes in a crisis, diabetes care is not routinely included in humanitarian health interventions. We here describe 4 factors that have contributed to the inequities and lack of diabetes inclusion in humanitarian programmes: (1) evolving paradigms in humanitarian health care, (2) complexities of diabetes service provision in humanitarian settings, (3) social and cultural challenges, and (4) lack of financing. We also outline opportunities and possible interventions to address these challenges and improve diabetes care among crisis-affected populations.
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Affiliation(s)
- Sylvia Kehlenbrink
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, 221 Longwood Avenue RFB-2, Boston, MA 02115, USA.
| | - Kiran Jobanputra
- Médecins Sans Frontières, Chancery Exchange, Lower Ground Floor, 10 Furnival Street, London EC4A 1AB, UK
| | - Amulya Reddy
- Médecins Sans Frontières, Chancery Exchange, Lower Ground Floor, 10 Furnival Street, London EC4A 1AB, UK
| | - Philippa Boulle
- Médecins Sans Frontières, Route de Ferney 140, Geneva 1202, Switzerland
| | - Apoorva Gomber
- Division of Global Health Equity, Brigham and Women's Hospital, Center for Integration Science, 75 Francis Street, Boston MA 02115, USA
| | - Rachel Nugent
- Department of Global Health, University of Washington, 3980 15th Avenue Northeast, Seattle, WA 98195, USA
| | - Vinod Varma
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin du Pommier 40, 1218 Grand-Saconnex, Geneva, Switzerland
| | - Anna T Nakayama
- International Alliance for Diabetes Action, 101 South Hanley Road, Suite 800, Saint Louis, MO 63105, USA
| | - Tom Ellman
- Médecins Sans Frontières, 9th Floor, Zurich House, 70 Fox Street, Marshalltown, Johannesburg 2001, South Africa
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Xing S, Liu Y, Zhang H, Li B, Jiang X. The mediating role of diabetes stigma and self-efficacy in relieving diabetes distress among patients with type 2 diabetes mellitus: a multicenter cross-sectional study. Front Psychol 2023; 14:1147101. [PMID: 37575426 PMCID: PMC10416640 DOI: 10.3389/fpsyg.2023.1147101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/08/2023] [Indexed: 08/15/2023] Open
Abstract
Background Patients with diabetes mellitus often suffer from diabetes distress. Social support and certain psychological factors potentially influence diabetes distress, but studies exploring the mechanisms underlying these relationships are scarce. Objectives To reveal the associations between social support, diabetes stigma, diabetes self-efficacy, and diabetes distress among patients with type 2 diabetes and the underlying mechanisms linking these variables. Design and methods A multicenter cross-sectional study was adopted and a sample of 431 patients with type 2 diabetes was investigated. Social support, diabetes stigma, diabetes self-efficacy, and diabetes distress were surveyed with the Perceived Social Support Scale, Type 2 Diabetes Stigma Assessment Scale, Self-Efficacy for Diabetes Scale, and Diabetes Distress Scale, respectively. The hypothesized model was verified using structural equation modeling. Results Social support and diabetes stigma had direct associations with diabetes distress. Diabetes stigma mediated the association between social support and diabetes distress, and the association between diabetes self-efficacy and diabetes distress. Diabetes stigma and self-efficacy exerted a chain mediation effect on the association between social support and diabetes distress. Conclusion Social support and diabetes stigma were significant predictors of diabetes distress. Diabetes stigma and self-efficacy play essential mediating roles in relieving diabetes distress. This can provide guidance for the development of evidence- and theory-based interventions. Culturally sensitive interventions that aim to provide ongoing social support, decrease diabetes stigma, and enhance self-efficacy have the potential to relieve diabetes distress.
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Affiliation(s)
- Shuping Xing
- International Nursing School, Hainan Medical University, Haikou, Hainan, China
| | - Yeling Liu
- International Medical Service Centre, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Hua Zhang
- International Nursing School, Hainan Medical University, Haikou, Hainan, China
| | - Bin Li
- Department of Nursing Management, Hainan General Hospital, Haikou, Hainan, China
| | - Xinjun Jiang
- International Nursing School, Hainan Medical University, Haikou, Hainan, China
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