TY - JOUR

T1 - 'Is Insulin Right for Me?' Development of a theory-informed, web-based resource for reducing psychological barriers to insulin therapy in type 2 diabetes

AU - Holloway, Edith E.

AU - Speight, Jane

AU - Furler, John

AU - Hagger, Virginia

AU - O'Neal, David N.

AU - Skinner, Timothy C.

AU - Holmes-Truscott, Elizabeth

N1 - Funding Information: Funding This work was largely supported by Sanofi-Aventis Australia (Sanofi) grant number SA-2017–11697 ISS. Costs associated with participation incentives were funded, and website design support partially funded, by the ACBRD. In-kind support including project oversight was provided by the Investigator team. JS and EH-T are supported by core funding to the ACBRD provided by the collaboration between Diabetes Victoria and Deakin University. EH-T is also supported by a Deakin University Dean’s Postdoctoral Fellowship. Publisher Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2021/9/24

Y1 - 2021/9/24

N2 - Objective To develop a theory and evidence-based web intervention to reduce psychological barriers towards insulin therapy among adults with non-insulin-treated type 2 diabetes (T2D). Methods Salient psychological barriers towards insulin were identified from the literature and classified using the Theoretical Domains Framework (TDF). Relevant TDF domains were mapped to evidence-based behaviour change techniques (BCTs), which informed the content for each barrier. Acceptability was explored using cognitive debriefing interviews (n=6 adults with T2D). Results 'Is Insulin Right for Me' addresses eight barriers, phrased as common questions: Does insulin mean my diabetes is more serious? Do insulin injections cause complications? Is it my fault I need to inject insulin? Will I gain weight? Will injecting hurt? What about hypos? Will injecting insulin be a burden? What will others think of me? BCTs, including persuasive communication and modelling/demonstration, were delivered using appropriate methods (eg, demonstration of the injection process). Participant suggestions for improvement included clear and direct messages, normalising insulin and avoiding confronting images. Conclusions 'Is Insulin Right for Me' is the first theory and evidence-based, web intervention designed to reduce psychological barriers towards insulin therapy for adults with T2D. Evaluation is needed to determine its impact on negative appraisals and receptiveness towards insulin.

AB - Objective To develop a theory and evidence-based web intervention to reduce psychological barriers towards insulin therapy among adults with non-insulin-treated type 2 diabetes (T2D). Methods Salient psychological barriers towards insulin were identified from the literature and classified using the Theoretical Domains Framework (TDF). Relevant TDF domains were mapped to evidence-based behaviour change techniques (BCTs), which informed the content for each barrier. Acceptability was explored using cognitive debriefing interviews (n=6 adults with T2D). Results 'Is Insulin Right for Me' addresses eight barriers, phrased as common questions: Does insulin mean my diabetes is more serious? Do insulin injections cause complications? Is it my fault I need to inject insulin? Will I gain weight? Will injecting hurt? What about hypos? Will injecting insulin be a burden? What will others think of me? BCTs, including persuasive communication and modelling/demonstration, were delivered using appropriate methods (eg, demonstration of the injection process). Participant suggestions for improvement included clear and direct messages, normalising insulin and avoiding confronting images. Conclusions 'Is Insulin Right for Me' is the first theory and evidence-based, web intervention designed to reduce psychological barriers towards insulin therapy for adults with T2D. Evaluation is needed to determine its impact on negative appraisals and receptiveness towards insulin.

KW - general diabetes

KW - public health

KW - qualitative research

UR - http://www.scopus.com/inward/record.url?scp=85116163457&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2020-045853

DO - 10.1136/bmjopen-2020-045853

M3 - Journal article

C2 - 34561252

AN - SCOPUS:85116163457

VL - 11

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

M1 - e045853

ER -