Original Research

Service user preferences for diabetes education in remote and rural areas of the Highlands and Islands of Scotland


Jenny Hall1 PhD, Research Fellow *

Fiona Skinner2 PhD, Subject Network Leader Applied Life Studies

Phil Tilley3 RMN, Former Deputy Head Planning and Development (retired)

Sandra MacRury4 MD, FRCP, Professor of Clinical Diabetes


1 University of the Highlands and Islands, Department of Rural Health and Wellbeing, Centre for Health Science, Old Perth Road, Inverness IV2 3JH, UK

2, 4 University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, UK

3 NHS Western Isles, Stornoway, Isle of Lewis HS1 2BB, UK

ACCEPTED: 30 June 2017

early abstract:

Introduction: Diabetes prevalence in Scotland is 5.3%, with type 2 diabetes accounting for 86.7% of all cases in the Highlands and 85.7% in the Western Isles. Structured education is a key component in the management of this chronic disease. However, current group session models are less feasible in lower-population non-urban environments due to distance, participant numbers and access to appropriately trained health care professionals. Group sessions may also be a less attractive option in small communities where people tend to have close day-to-day personal contact. This study assesses the access and delivery preferences of remote and rural service users in the Highlands and Western Isles to structured diabetes education programmes.
Methods: The study used a mixed methods approach of focus groups and questionnaires with people with type 2 diabetes in the Highlands and Islands of Scotland. Both modes of participation were designed to explore perception of diabetes knowledge, diabetes education and use of technology.
Results: One-to-one delivery was the delivery method of choice, however there was a preference for a digital approach over group education sessions. Service users expressed a strong desire to be able to learn at their own pace, when and where they wanted to, and with no requirement to travel. To address these requirements an online resource, providing access to both learning sessions and trusted sources of information, was the preferred mode of delivery.
Conclusions: People with type 2 diabetes living in remote and rural areas of the Scottish Highlands and Islands who already use the internet are receptive to the use of digital technology for delivery of diabetes education and are interested in learning more about management of their condition through this medium. They believe that a technology approach will provide them with more control over the pace of learning and where and when this learning can take place.