A Participatory Action Research study to implement evidence

Aim: This study aimed to explore and implement some of these findings by designing an interventional framework to cater for the needs of ethnic minority groups (EMGs) with diabetes in Coventry.

Methods: A purposive participatory case study was conducted in one Coventry inner-city practice between April 2012 and March 2013, using weekly participant observations, monthly participatory group meetings and one post-participatory one-to-one semi-structured interview with three patients, four general practice (GP) staff and two multilingual link workers (MLWs). Data were analysed using qualitative methods. The research explored cultural issues with staff and patients within the GP and designed a culturally-competent diabetes service framework.

Findings: The operational activities of this general practice involving staff and patients demonstrated both strongly evidence-based culturally-competent and less culturally-sensitive practices. For instance, some ethnic minority patients with cultural differences were consulted by healthcare professionals from the same ethnic backgrounds, thereby ensuring cultural and linguistic concordances. However, there were also occasions where children interpreted for their parents and where patients with language barriers consulted without the use of professional or lay interpreters. The practice prioritised the designing of a Diabetes Specialist Multilingual Link Worker model, to reduce the inequality in diabetes primary care service provision. Key elements of the model were specialist training and education, function of the multilingual link worker, information sharing, partnership working, and service commissioning.

Conclusions: A Diabetes Specialist Multilingual Link Worker Framework to address deficits in general practice cultural competence was developed for pilot testing. The involvement of a broad group of stakeholders ensures interventions to improve EMGs’ access to effective diabetes care in primary care are appropriate and feasible. This may ultimately result in greater effectiveness.