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Hi there, I am a nursing student who has 13 weeks of practicum at a community drop in centre. With this time I have been asked to develop and deliver a diabetes education prevention program to some of the street involved, low income, new immigrants and refugee clients there. I am finding this very challenging because i feel like i know what they want me to do- design a couple of workshops about increasing fibre intake and decreasing sugar or something, so that I get an A in the course. It would be easy enough to produce a bunch of pamphlets, but there is not sustainability or capacity building... and that it would be nearly impossible to design let alone deliver, and evaluate any kind of meaningful, sustainable program in the next 13 weeks. i guess i am just venting a bit, but i don`t want to play into this kind of `pat yourself on the back for making educational materials that no one will read, but at least we can grade you on them` game. However, it feels like a very daunting task to begin... currently i am searching Toronto for experienced diabetes nurses who have worked with this type of population i am wondering how to engage the population in program design, etc., like participatory action projects... do you have any suggestions? thanks so much
Answer:

Courage, Sarah! This is a great question that raises several levels of response: First, take a look at our Table of Contents, particularly Parts B and C. Other Parts may become relevant as you proceed. Second, decide whether you want to design and develop something that meets the needs of your supervisors or of the street-involved diabetics. (I take it from your preliminary rant that you prefer the latter!) Third, consider hiring some street-involved persons with Diabetes as consultants to help you design an education program that would be more meaningful to them. You should pay them in some way: money, healthy food, or whatever. Payment acknowledges their expertise and encourages more participation. The drop in center staff and the nurses you mentioned can help identify and recruit street-involved persons with Diabetes. Fourth, Gather those persons into a focus group, explain your purpose, and ask them to talk about what information gleaned from their own experience with Diabetes onset, recognition, and management might have helped them and might be really helpful to others. Fifth, listen to them very actively, and do a lot of reflecting back what they say, so they know you are listening, and so you can get confirmation that you have heard accurately. Take notes. Sixth, ask them to suggest the best ways (modalities) to deliver the information to other street-involved people. (A good brainstorming exercise.) Seventh, Gather them again at a later date and ask them to review and comment on whatever materials and strategies you developed from their suggestions. (See also the Table of Contents section on developing strategic and action plans. By that point, you will have developed and delivered a diabetes education program (with and to your street-level consultants) that may or may not be different and unexpected, but possibly more relevant to the target audience. Eighth, Get your supervisor's permission before you proceed. You might offer to help write a grant application later, to evaluate the program.

Question Date: Sat, 09/20/2008