Background: The objectives of this study were twofold (i) to develop the Diabetes Manual, a selfmanagement
educational intervention aimed at improving biomedical and psychosocial outcomes
(ii) to produce early phase evidence relating to validity and clinical feasibility to inform future
research and systematic reviews.
Methods: Using the UK Medical Research Council's complex intervention framework, the
Diabetes Manual and associated self management interventions were developed through preclinical,
and phase I evaluation phases guided by adult-learning and self-efficacy theories, clinical
feasibility and health policy protocols. A qualitative needs assessment and an RCT contributed data
to the pre-clinical phase. Phase I incorporated intervention development informed by the preclinical
phase and a feasibility survey.
Results: The pre-clinical and phase I studies resulted in the production in the Diabetes Manual
programme for trial evaluation as delivered within routine primary care consultations.
Conclusion: This complex intervention shows early feasibility and face validity for both diabetes
health professionals and people with diabetes. Randomised trial will determine effectiveness against
clinical and psychological outcomes. Further study of some component parts, delivered in
alternative combinations, is recommended
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