Improving diabetes care
Many people with diabetes still face significant challenges in areas including self-management, adherence, access to support and involvement in care. Healthcare systems are struggling to accommodate person-centred models of care and to encourage people with diabetes to self-manage their condition. All this is happening while the internet and social media – is opening up unprecedented opportunities for social support and empowerment.
Diabetes Attitudes Wishes and Needs 2 (DAWN2) has three goals:
- To better understand the unmet needs of people with diabetes and their caretakers,
- To facilitate dialogue and collaboration among key stakeholders to strengthen active patient involvement and self-management,
- To establish a multinational survey system for assessing and bench-marking psychosocial and educational aspects of diabetes care delivery.
Health Promotion Research at Steno Diabetes Center – was a member of the partnership for the DAWN2 study. Health Promotion Research has been part of the development of the scientific part of the study and is now involved in the processing and writing of the data. Areas of special interest are diabetes education, social support and family member issues.
Design, method and theory
DAWN2 is a multinational, interdisciplinary and multi-stakeholder study conducted across four continents in 17 countries: Algeria, Canada, China, Denmark, France, Germany, India, Italy, Japan, Mexico, the Netherlands, Poland, Russian Federation, Spain, Turkey, UK and the US.
A questionnaire was developed including a number of validated scales. It was reviewed and approved in English, then translated and cross-culturally adapted into the primary language(s) of each participating country.to ensure harmonization. The questionnaire was reviewed by the DAWN2 advisory board in each country and pilot-tested with representatives of the respondent group before the study was initiated.
The DAWN2 study involves more than 15,000 participants: 8,596 people with diabetes, 2,057 family members and 4,785 healthcare professionals (2,066 primary care physicians/general practitioners, 1,350 diabetes specialists, 827 nurses and 542 dieticians).
The DAWN2 data highlight that diabetes continues to represent a major psychological burden for people with diabetes and their families.
It also demonstrates the importance of active engagement of people with diabetes, those around them in diabetes care, and the significance of social support from different sources.
Diabetes affects physical, emotional, social and financial aspects of life across cultures and countries, and gaps in care exist around psychosocial and self-management education and support.
Significant country variations
The DAWN2 study shows significant country variations in indicators of person-centred diabetes care and psychosocial outcomes of diabetes. Most people with diabetes are not actively engaged by their healthcare professionals to take control of their condition. Education and psychosocial care are often unavailable.
The DAWN2 study provides new insights that may help identify unmet needs and best practices to drive changes that improve outcomes for people with diabetes.
The DAWN2 study is a global partnership initiative between several established national and international organizations, including the International Diabetes Federation, the International Alliance of Patients’ Organizations (IAPO) and the Steno Diabetes Center, and Novo Nordisk A/S.
Examples of DAWN2 publications
Joensen et al. 2016, Hansen UM et al. 2015, Jones A et al. 2016, Peyrot et al. 2012, Nicolucci et al. 2013, Kovacs Burns et al. 2013, Holt et al. 2013.