‘It's an important part, but I am not quite sure that it is working’: educators’ perspectives on the implementation of goal-setting within the ‘DAFNE’ diabetes structured education programme

Aim: To explore educators’ perspectives on the implementation of goal-setting and action-planning strategies within a structured diabetes self-management education programme. Methods: Ten semi-structured interviews were conducted with diabetes self-management education providers delivering the ‘Dose Adjustment for Normal Eating’ (DAFNE) programme to people with Type 1 diabetes throughout Ireland. A pre-designed topic guide, focused on exploring educators’ experiences of delivery and application and views on usefulness of goal-setting strategies, was used in all interviews. The interviews were recorded, transcribed and analysed using thematic analysis. Results: Five main themes were identified: ‘people need a plan’, discussing perspectives on goal-setting's value; ‘the power of the group’, highlighting the impact a group format has on goal-setting practices; ‘diversity and individuality’, discussing differences in DAFNE participants’ and educators’ engagement with goal-setting; ‘goal-setting's fit’, exploring perspectives on how well goal-setting fits within diabetes self-management education and follow-up care; and ‘feelings of inadequate psychological knowledge’, addressing challenges experienced in the delivery of goal-setting components. Conclusion: While educators saw benefits in the implementation of goal-setting and planning strategies within diabetes self-management education, concerns about how well goal-setting currently fits within diabetes self-management education and follow-up care were evident. Additionally, many educators experienced the delivery of goal-setting and action-planning strategies as challenging and would value additional training opportunities.