Development and evaluation of a health behaviour change intervention to reduce risk of vision loss for young adults with type 2 diabetes

Dr Amelia J Lake,  Research Fellow, The Australian Centre for Behavioural Research in Diabetes

Young adults with type 2 diabetes (aged 18-39 years), face increased risk of early onset and rapid progression of diabetic retinopathy, a leading cause of vision loss. Retinal screening is essential for the early detection of diabetic retinopathy; yet screening rates for this group are low, leading to calls for development of cohort-specific eye health resources. Using a mixed-methods approach, we conducted a comprehensive needs assessment which demonstrated that although the majority of previous individual-level retinal screening promotion interventions focussed on increasing knowledge and awareness of diabetic retinopathy and retinal screening guidelines, social cognitive factors, such as attitudes and beliefs also play an important role. Our mixed methods studies highlighted salient motivational factors impacting retinal screening behaviour. For example, young adults believed that they were at low risk of diabetic retinopathy, gave retinal screening low priority, and were not engaged with existing services which they viewed as designed for ‘older’ adults. Utilising intervention mapping, cohort-specific determinants were mapped to evidence-based persuasive messaging and incorporated into a print-based leaflet. The leaflet was subject to stakeholder review including with members of the priority population, and continues to be periodically distributed to newly-diagnosed young adults with type 2 diabetes, via existing infrastructure. This program of research was developed and trialled within real-world conditions and illustrates the process involved in maximising engagement and relevance of health behaviour interventions to the target audience. Our experience also highlights the importance of taking a flexible approach to health behavior change intervention development for a ‘hardly-reached’ population.

About the speaker: Dr Amelia J Lake is a Research Fellow at The Australian Centre for Behavioural Research in Diabetes. Amelia joined the Centre in 2013 to manage the Diabetes and Eye Health Project, a Vision 2020 Australia-funded program to promote retinal screening for those at increased risk of vision loss from diabetic retinopathy. Amelia’s program of PhD research involved the development and evaluation of an evidence-based eye health resource for young adults with type 2 diabetes, one of the key priority populations within the Diabetes and Eye Health project. Amelia’s principle research interests focus on methods to promote translation and uptake of research findings in preventative health, the self-management of chronic conditions and in promoting health behaviour change. Amelia has a special interest in working with consumer and health professional groups to enable translation of evidence-based research into practice.