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Development and Impact of a Community-Delivered, Multisectoral Lifestyle Management Service for People Living With
Sjaan R Gomersall1, Denis Y Giguere2, Jacqueline Cotugno3
1Health and Wellbeing Centre for Research Innovation, School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Australia.
Background:
Type 2 diabetes is the fastest-growing chronic condition in Australia, with higher prevalence in disadvantaged groups. Logan Healthy Living by UQ Health Care is a proof-of-concept, interprofessional allied health clinic focused on supporting people with and at risk of type 2 diabetes in Logan, a region in South East Queensland, Australia, with high levels of health inequity. Logan Healthy Living is supported by the Queensland Government through Health and Wellbeing Queensland and a broader multisectoral alliance including primary health care; tertiary hospital and health services; and government, community, and university sectors.
Objective:
This paper describes the establishment of Logan Healthy Living and outlines the evaluation protocol for the service's type 2 diabetes lifestyle management program.
Methods:
The context and setting of Logan Healthy Living are presented, and the process for establishing the multisectoral partnerships, development and governance of the service, and the facility are described. The lifestyle management program is an 8-week, group-based program that includes 1 hour of education and 1 hour of supervised, individually tailored exercise each week. The theoretical underpinnings and the program are described in detail. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework will guide evaluation of the program and inform key questions regarding the number and characteristics of the clients (reach); diabetes-related distress, health behaviors (physical activity and diet), quality of life, self-management self-efficacy, loneliness, community involvement, anthropometric measures, hemoglobin A1c levels, physical function, and health care use (effectiveness); referral pathways (adoption); fidelity, appropriateness, acceptability, and costs (implementation); and long-term effectiveness (maintenance). Data will be drawn from a purposefully embedded minimum dataset and data registry, with the process for designing and embedding data collection into practice (via surveys, in-person measures, and client management software) described in detail.
Results:
Ethics approval has been obtained for the data registry. Logan Healthy Living is a 4-year proof of concept that concludes on December 31, 2024, with findings expected to be reported starting in 2025.
Conclusions:
While multisectoral responses are needed for complex community health challenges, the processes for achieving these are rarely documented, and the description of the development of Logan Healthy Living has the potential to inform future partnerships. The findings of the evaluation will provide important new knowledge on the impact of a community-delivered type 2 diabetes program on individuals, the community, and the health system in an area of high health inequity.
International Registered Report Identifier (Irrid):
DERR1-10.2196/69477.
