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- Title
A critique of the design, implementation, and delivery of a culturally-tailored self-management education intervention: a qualitative evaluation.
- Authors
Sidhu, Manbinder S.; Gale, Nicola K.; Gill, Paramjit; Marshall, Tom; Jolly, Kate
- Abstract
Background: Self-management education is at the forefront of addressing the increasing prevalence of chronic diseases. For those at greatest risk, such as minority-ethnic and/or socio-economically deprived groups, self-management education can be culturally-tailored to encourage behavioural change. Yet, the application of culturally appropriate material and expertise within health promotion services continues to be debated. We critique the design, implementation, and delivery of a culturally-tailored self-management intervention, with particular focus on the experiences of lay educators. Methods: A mixed methods qualitative evaluation was undertaken to understand self-management service provision to culturally diverse communities (i.e. how components such as lay workers, group-based design, and culturally-appropriate educational material are intended to encourage behavioural change). We interviewed lay educators delivering the Chronic Disease Educator programme along with attendees, whilst observing workshops. Data were thematically analysed using a content-based constant comparison approach through a number of interpretative analytical stages. Results: Lay educators felt part of the local community, relating to attendees from different races and ethnicities. However, lay educators faced challenges when addressing health beliefs and changing lifestyle practices. Culturally-tailored components aided communication, with educator's cultural awareness leading to close relationships with attendees, while the group-based design facilitated discussions of the emotional impact of illness. Conclusions: Lay educators bring with them a number of nuanced skills and knowledge when delivering self-management education. The development and training required for this role is inhibited by financial constraints at policy-level. The interpretation of being from the 'community' links with the identity and status of the lay role, overlapping notions of race, ethnicity, and language.
- Subjects
CHRONIC diseases; CORONARY disease; PEOPLE with diabetes; KIDNEY diseases; EDUCATIONAL programs; PATIENTS
- Publication
BMC Health Services Research, 2015, Vol 15, Issue 1, p1
- ISSN
1472-6963
- Publication type
Article
- DOI
10.1186/s12913-015-0712-8