Eric Lowndes talks about his experiences of attending an NHS behaviour change programme and working with two independently funded evaluation teams

Eric Lowndes talks about his experiences of attending an NHS behaviour change programme to reduce his chances of progressing to type 2 diabetes. Since then he has worked with University of Manchester researchers on two National Institute of Health Research (NIHR) funded evaluations of national behaviour change programmes, one looking at the very programme he has experienced himself, and the other focussing on people with type 2 diabetes.

“After a routine health check up, I was shocked to discover that my blood test results indicated that I was close to the threshold for type II diabetes and I was warned of the potential damage that could follow. I was invited to join an on-line programme designed to educate me about type II diabetes and to monitor my progress, as I hopefully lost a little weight and improved my diet. As part of the programme I was also encouraged to count my steps as a way of focussing on my levels of exercise.

Each day I monitored my results and each month I was telephoned by a nurse who educated me about food types. The information I received was interesting. I was surprised to learn that consuming my ‘five a day’ by scoffing five tangerines in the evening was not the best way towards good health after all! 

Luckily, I was a keen footballer and I joined a walking football club. So, with a combination of movement and a better diet I have become a little less heavy and a bit fitter, and I now understand that being more considerate about my lifestyle can help me in the longer term. However, I do still avoid having my bloods checked because now the programme is over, I don’t really want to discover that I could be tiptoeing back towards the type II diabetes threshold again. I wonder, if this is typical of other people? 

After these experiences imagine my surprise at being invited to participate in Patient and Public Involvement groups within research studies into type 2 diabetes. My involvement (which includes listening, learning and asking questions of the researchers) is something I want to share with you. 

The first study is called DIPLOMA, it is the independently funded evaluation of The NHS Diabetes Prevention Programme; this is the programme I experienced in Salford.

The research team form the University of Manchester, many of which are also involved with NIHR Applied Research Collaboration Greater Manchester (ARC-GM), are investigating how effective the training programmes offered by the national programme are for people at risk of type 2 diabetes. I experienced one type of intervention, but there are several others, which are delivered as part of the national programme, and it is important that we know if these programmes work as efficiently as possible. 

Some people at risk of type 2 diabetes get together at regular group meetings to learn, discuss and improve their lifestyles. Others are encouraged to try to do the courses on-line. Often, the providers are not necessarily from the NHS, they may be private companies or social enterprises who are contracted by the NHS to run the courses. It’s vital that our money is being used effectively. 

The second study I am involved with, is the evaluation of the NHS Healthy Living Diabetes Programme. This focusses on how people who have type II diabetes can best control their condition using the latest digital technology, by the means of a website. 

Many people, some of whom live in remote areas and especially the pre-retired who live time- pressured and busy lives, often can’t attend group meetings. These people are likely to be ‘tech savvy’ and are more used to using modern technology than some of my retired friends. COVID-19 has highlighted the difficulty of keeping physical appointments while living in the modern world and for many younger or up-to-date patients’ digital platforms are a great option for monitoring their health.

 Our research team is looking at a range of topics as part of the evaluation, but it’s particularly interesting for me to understand how the website can be accessed and how it can be used to best control the condition of the people who use it.

Both studies are major pieces of work and they could benefit many thousands of people who are either on the threshold of developing type 2 diabetes, or those who are already living with type 2 diabetes. There is a lot riding on these programmes and their evaluations. If type II diabetes can be better controlled remotely, there are potentially great savings for the system and better health outcomes for people who access them. 

As long as this doesn’t leave us oldies behind, I’m all for it.” 

Eric Lowndes is involved as a lay member in research projects undertaken by The NIHR Applied Research Collaboration Greater Manchester and the University of Manchester. You can find out more about the two studies Eric is involved in here:

• The evaluation of the NHS Diabetes Prevention Programme (DIPLOMA)
• The evaluation of the NHS Health Living Diabetes Programme (HED-LINE)

DIPLOMA represents independent research funded by the National Institute for Health Research [Health Services and Delivery Research, 16/48/07 – Evaluating the NHS Diabetes Prevention Programme (NHS DPP): the DIPLOMA research programme (Diabetes Prevention – Long Term Multimethod Assessment)].  

HED-LINE represents independent research funded by the National Institute for Health Research [Policy Research Programme, NIHR200933/Healthy Living Diabetes - Long-term Independent National Evaluation (HED-LINE) of part of the NIHR].

The views and opinions expressed in this presentation are those of the authors and do not necessarily reflect those of the NHS, the National Institute for Health Research or the Department of Health and Social Care