Acceptability of using trained lay people to deliver diabetes self-management education: a qualitative investigation using data from patients and educators

Aims: Quantitative findings from the DESMOND Lay Educator Trial have indicated that patients obtain equivalent benefits from self-management education delivered by one trained lay educator and one healthcare professional educator compared with sessions delivered by two healthcare professional educators. This sub-study aimed to explore, qualitatively, the use of lay educators, particularly in terms of perceived acceptability.

Methods: Prior to attending their allocated session, patients were blinded to whether their two educators included one lay person. Semi-structured interviews, facilitated by a topic guide, were conducted with a purposive sample of 16 patients who attended a session delivered by a lay/healthcare professional educator team and 11 educators (lay and healthcare professional). Data were analysed thematically using a constant comparative approach including framework charting.

Results: Analysis suggested that, overall, using lay people to deliver DESMOND education was acceptable to patients and educators. Professional and lay educators generally described good working relationships and enjoyable experiences. A key theme emerged regarding educators’ levels of diabetes knowledge; however, patients were positive about involving lay educators regardless of perceptions about knowledge levels and whether or not they became aware of the composition of their educator team. Peer status and/or empathy were cited as beneficial characteristics of those lay educators with diabetes themselves or in a family member.


Conclusions: Qualitative findings have supported and helped to explain the positive quantitative trial results. Confirmation of acceptability is likely to influence the feasibility of rollingout the use of lay educators to deliver self-management education and thus increase capacity.