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Factors influencing attendance at structured education for Type 1 diabetes in south London
Author(s) -
Harris S. M.,
Shah P.,
Mulnier H.,
Healey A.,
Thomas S. M.,
Amiel S. A.,
Hopkins D.
Publication year - 2017
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13333
Subject(s) - medicine , demography , attendance , odds ratio , ethnic group , social deprivation , univariate analysis , diabetes mellitus , odds , population , gerontology , cross sectional study , logistic regression , multivariate analysis , endocrinology , environmental health , pathology , sociology , anthropology , economics , economic growth
Abstract Aim To investigate the factors influencing uptake of structured education for people with Type 1 diabetes in our local population in order to understand why such uptake is low. Methods We conducted a cross‐sectional database study of adults with Type 1 diabetes in two south London boroughs, analysed according to Dose Adjustment For Normal Eating ( DAFNE ) attendance or non‐attendance. Demographics, glycaemic control and service use, with subset analysis by ethnicity, were compared using univariate analysis. An exploratory regression model was used to identify influencing factors. Results The analysis showed that 73% of adults had not attended the DAFNE programme. For non‐attenders vs attenders, male gender (59 vs 48%; P = 0.002), older age (39 vs 35 years; P < 0.001), non‐white ethnicity (30 vs 20%; P = 0.001) and coming from an area of social deprivation (index of multiple deprivation score 31 vs 28; P < 0.001) were associated with non‐attendance. The difference in gender (88% men vs 70% women; P < 0.001) and age (43 vs 34 years) persisted in the non‐white group. Regression analysis showed that higher baseline HbA 1c level (odds ratio 1.96; P = 0.004), younger age (odds ratio 0.98; P = 0.001) and lower social deprivation (odds ratio 0.52; P = 0.001) was associated with attendance. Conclusion Socio‐economic status and factors perceived as indicating greater severity of disease (HbA 1c ) influence attendance at DAFNE . More work is necessary to understand the demography of non‐attenders to aid future service design and alternative engagement strategies for these groups.