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Diabetes

England has more than two million known diabetics, but a further half million have the condition without realising it.

Type 2 diabetes is often called a ‘silent killer’ because many people ignore its symptoms and underestimate the dangers. It causes blindness, heart disease, stroke and early deaths, so diagnosis is vital.

The risk of diabetes has always been high in minority ethnic communities, while today it is growing because of the upsurge in obesity. This means diabetes is a key factor in perpetuating health inequalities.

As a result, reaching missing diabetics is an important target within the national service framework. It’s also a challenging one. Dr Foster Intelligence can help you find out how many people are at risk in your community, who they are, and how to drive them to the right services for testing and treatment.

NHS North East Essex

The challenge

NHS North East Essex knew that type 2 diabetes was a rising problem and teamed up with Dr Foster Intelligence in January 2009 to raise awareness of the condition. The main objective was to get more over-45s to take a diabetes test. This was because everyone in this age group is considered to be at high risk of the condition.

What we did

We helped inform the campaign strategy by analysing demographic information and local data-sets. Through the Yorkshire and Humber Public Health Observatory modelling tool we determined that about 2,000 diabetics remained undiagnosed. Over half of the diabetes admissions to hospital were repeats, pointing to problems with access. Admissions were also more likely from those living in deprived or coastal areas.

To back up this analysis we then carried out qualitative research into screening and the management of diabetes. Focus groups and in-depth interviews helped to identify key factors influencing the target audience’s behaviour.

Armed with this insight, we worked with the PCT to put together a programme of community engagement to encourage local over-45s to take a diabetes test. A humorous concept was considered to be most likely to attract and engage the audience, so our creative team developed a 1970s-themed campaign using eye-catching images taken from that decade.

With a VW camper van and chopper bike acting as focal points, a field marketing team engaged the local public and gained their permission to book a diabetes test. This was all supported by highly visible bus shelter advertisements around Colchester, posters in pharmacies, and coverage in the local media.

The outcome

During the month-long campaign more than 2,000 people gave their contact details and agreed to be invited for diabetes testing through the PCT or local pharmacies.

Beyond its short-term aims, the social marketing activity also laid the ground for a longer-term push against health inequalities; the campaign built rapport with the target audience by capturing their imagination and opening effective communications channels. This left the PCT in a good position to help people understand more about the small lifestyle changes that reduce the risk of type 2 diabetes, and ultimately to signpost them to relevant services such as weight management if necessary.

Other work on diabetes

Dr Foster’s diabetes initiative in Slough broke new ground in social marketing. Our campaign in 2004 showed that careful targeting can influence people’s behaviour and bring benefits for local NHS organisations. It also acted as a launch-pad for future social marketing projects.

The Department of Health had asked us to find new ways of raising awareness of type 2 diabetes for Slough PCT (now part of NHS Berkshire East). The aim was to prompt more people to take a diabetes test so that, if necessary, they could get the treatment they needed.

Through research we found that only 4% of Slough’s population were diagnosed with diabetes even though 7% were likely to have it. Also, 27% of the population were of South Asian origin, especially Bangladeshi, who are generally at higher risk.

Qualitative research and lifestyle data analysis shed valuable light on the behaviour and attitudes of this audience. We also knew precisely which postcodes we had to target, by mapping where the level of risk was more than twice the national average.

Our ‘Action Diabetes’ campaign was tailor-made for the Slough population. In order to reach the community directly, local diabetes patients acted as volunteer health counsellors and visited high-risk individuals in residential areas. A mobile testing bus went to workplaces and shopping and leisure centres.

Importantly we had health information in different languages, plus a free health magazine. Local media coverage also raised the campaign’s profile further. Saeed Jaffrey gave celebrity support and health minister John Hutton attended the launch.

Results met the objectives. In fact, there was a 264% increase in referrals in the six months following the launch of Action Diabetes, compared with the equivalent period in the year before. Professor Mike Pringle of Nottingham University carried out a full independent evaluation.

Grace Vanterpool, who was diabetes clinical lead at Slough PCT, explained, “This type of social marketing is a simple thing, but it works – and the same principles can be applied to any chronic condition.”