title: Factors influencing attendance at structured education for Type 1 diabetes in south London.
abstract: To investigate the factors influencing uptake of structured education for people with Type 1 diabetes in our local population in order to understand why such uptake is low.
  
  
  
  We conducted a cross-sectional database study of adults with Type 1 diabetes in two south London boroughs, analysed according to Dose Adjustment For Normal Eating (DAFNE) attendance or non-attendance. Demographics, glycaemic control and service use, with subset analysis by ethnicity, were compared using univariate analysis. An exploratory regression model was used to identify influencing factors.
  
  
  
  The analysis showed that 73% of adults had not attended the DAFNE programme. For non-attenders vs attenders, male gender (59 vs 48%; P = 0.002), older age (39 vs 35 years; P < 0.001), non-white ethnicity (30 vs 20%; P = 0.001) and coming from an area of social deprivation (index of multiple deprivation score 31 vs 28; P < 0.001) were associated with non-attendance. The difference in gender (88% men vs 70% women; P < 0.001) and age (43 vs 34 years) persisted in the non-white group. Regression analysis showed that higher baseline HbA1clevel (odds ratio 1.96; P = 0.004), younger age (odds ratio 0.98; P = 0.001) and lower social deprivation (odds ratio 0.52; P = 0.001) was associated with attendance.
  
  
  
  Socio-economic status and factors perceived as indicating greater severity of disease (HbA1c) influence attendance at DAFNE. More work is necessary to understand the demography of non-attenders to aid future service design and alternative engagement strategies for these groups.
authors.affiliation: Institute of Diabetes, Endocrinology and Obesity, King's Health Partners, London, UK.|Health Innovation Network, London, UK.
authors.forename: S M
authors.identifier: 0000-0002-0528-2575
authors.initials: SM
authors.lastname: Harris
authors.affiliation: Institute of Diabetes, Endocrinology and Obesity, King's Health Partners, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Shah
authors.affiliation: Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Mulnier
authors.affiliation: King's Health Economics and Centre for Implementation Science at Institute of Psychiatry, Psychology and Neuroscience, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Healey
authors.affiliation: Institute of Diabetes, Endocrinology and Obesity, King's Health Partners, London, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Thomas
authors.affiliation: Institute of Diabetes, Endocrinology and Obesity, King's Health Partners, London, UK.|Diabetes Research Group, King's College London, London, UK.
authors.forename: S A
authors.initials: SA
authors.lastname: Amiel
authors.affiliation: Institute of Diabetes, Endocrinology and Obesity, King's Health Partners, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Hopkins
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D005006:Ethnicity; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data; D010358:Patient Participation / Q000523:psychology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
chemical_list: D001786:Blood Glucose