Delivering DESMOND to Participants with Intellectual Disabilities
You may have heard that DESMOND is working with a team of researchers from Northern Ireland to test out a fully adapted version of the Newly Diagnosed and Foundation participant programme which is great news. In the meantime if you are looking to adapt your delivery to deliver to a group of participants with intellectual disabilities please read on for our key considerations - please do get back in touch with any extra top tips that we can add to help other DESMOND teams do the same:
Structure/Format:
Consider delivering the DESMOND course in the format of the 3 x 2hr sessions which is currently proposed as an option for DESMOND virtual delivery (see image below). However, explore the option of making the sessions longer, for example 2hrs 30 minutes to allow for a 15 minute break half way through, which then provides you with an extra 15 minutes to recap any information as required/adopt a slightly slower pace for delivery. This can help meet individuals’ concentration and learning needs.
Carers:
Encourage carers to attend alongside participants if feasible.
Resources:
Consider providing carers with the DESMOND NDF Handbook.
Consider providing participants the health profile and action plans alongside some easy read materials such as these examples or your service may have something similar. Example 1 Example 2 (please see other useful documents at the bottom)
Ensure all previously generated flip charts are on display during each session to help aid recall.
Consider using red and green or smiley face stickers for participants to indicate how they feel about their personal results when plotting them on their health profiles.
Reducing the written word where possible can help to reduce barriers consider replacing food activity header cards with simple coloured card such as red, amber, green.
If you would like to consider using imagery instead of written word on flip charts then this pack may be useful – it was previously designed for another purpose but with some consideration could be adapted for this purpose
Language:
The use of language should be kept simple to ensure it meets the needs of the participants with intellectual disabilities. Therefore, easy-to-use language is necessary as well as the use of images for participants where possible.
Tips on language:
Blood sugar not blood glucose
Body parts/organs
Blood fats not cholesterol
Damage to the body not complications
Diabetes during pregnancy not gestational diabetes
·Body shape not weight
Being active instead of physical activity
Being less active instead of inactivity/sedentary behaviour/lifestyle
Someone in the family has Type 2 diabetes instead of family history or genetics
Flip charts:
· Consider having a separate flip chart within the participant story to record carers’ questions.
· Consider changing the title of the flip charts to:
1. Blood sugar
2. Blood fat
3. Blood pressure
4. Smoking
5. Body shape
6. Feeling sad
Blood Sugar:
Take tablets or insulin
Be more active
Lose weight/reduce waist
Eat less sugary foods
Eat smaller portions of starchy foods
Blood Fat:
Eat less fat
Be more active
Take tablets
Eat more fruit and vegetables
Blood Pressure:
Be more active
Take tablets
Have less salt
Eat smaller portions
Drink less alcohol
Lose weight/reduce waist
Eat more fruit and vegetables
Smoking:
Smoking groups
Set a stop date
Support from family and friends
Patches, inhalers, gum
Body Shape:
Be more active
Drink less alcohol
Eat smaller portions
Eat less fat
Eat more fruit and vegetables
Feeling Sad:
Take tablets
Be more active
Support from family and friends
Talk to your doctor/nurse
Talking therapy
Delivery:
· Consider asking carers if they have anything to add to the participant story.
We hope that these considerations are helpful, if we can help further in any way please do not hesitate to get in touch. We have added below a number of articles and documents that we have collated from other sources that you may also find useful: