Friendly welcome

Refreshments offered (tea, coffee, water) ***OPTIONAL – Depends on location***

Introductions

Confidentiality agreement (e.g. what is said in the room, stays in the room etc.)

Course aims and objectives (brief run-through of what the programme will entail)

Opportunity for participants to ask questions

Participants asked about what they expect from the programme (e.g. hopes and fears)

Assess importance and confidence in making healthy lifestyle changes

Assess understanding of the condition (knowledge prior to the course beginning)

Overview of what diabetes/pre-diabetes is

Overview of complications associated with diabetes

Introduce 5 key healthy lifestyle messages (1. Eating a healthy diet, 2. Undertaking regular activity, 3.

Achieving and maintaining a healthy weight, 4. Positive mental health and wellbeing, 5. Making healthy lifestyle choices)

Explore benefits and challenges to change (understand journey and available support, understand and address potential barriers, reference to the stages of change model)

Clinical metrics explained (understand what readings mean, what normal/high levels are, and reasons for reviewing them)

Signpost to Health Care Professional (e.g. how to access local HCP) ***OPTIONAL – Only if participant mentions issue***

Goal setting (ensure participants are aware of what they would like to achieve from attending the course, and encourage behaviour change, reference to SMART goals, use goal setting tool)

Food and activity diaries (introduce/remind participants to complete food and activity diaries for the following weeks' sessions)

Opportunity and encouragement for participant-led group discussion

Session 2: Healthy eating

Level of implementation

Notes

Low/Not observed

Observed to a small degree

Observed to a medium degree

High implementation

Friendly welcome

Refreshments offered (tea, coffee, water) ***OPTIONAL – Depends on location***

Recap previous week’s session (“Diabetes/pre-diabetes and a healthy lifestyle”)

Opportunity for participants to ask questions

Assess retention from Session 1 (assess group and individual understanding, signpost for further support if required)

Assess group and individual understanding of healthy eating

Assess importance and confidence to make healthy dietary changes (encourage group interaction, motivation, and behaviour change)

Discuss the importance of low fat and high fibre diets for diabetes prevention/management

Introduction to the “Eatwell Plate”

Discussion about each of the food groups (fat, carbohydrates, dairy, protein, fruit, vegetables, drinks and alcohol)

Barriers to healthy eating (discussion around the group's perceived barriers to healthy eating and possible solutions)

Food labelling (awareness of food labelling and terms to watch out for on packaging, use example packaging as reference)

Food diaries – dietary assessment (individual and group understanding of current diet, and identification of ways in which to improve)

Positive thinking (introduce the group to the concept of positive thinking)

Goal setting (understanding of how goals can be achieved, encourage behaviour change, use goal setting tool)

Activity diary (remind participants to complete activity diary in time for

Session 3)

Opportunity and encouragement for participant-led group discussion

Session 3: Physical activity

Level of implementation

Notes

Low/Not observed

Observed to a small degree

Observed to a medium degree

High implementation

Friendly welcome

Refreshments offered (tea, coffee, water) ***OPTIONAL - Depends on location***

Recap previous week’s session (“Healthy eating”)

Review food diaries/ progress (allow participants to raise concern over food eaten and guide them in making positive changes to their diet)

Opportunity for participants to ask questions

Assess retention from Session 2 (assess group and individual understanding, signpost for further support if required)

Assess importance and confidence to increase physical activity (encourage group interaction, motivation, and behaviour change)

Discuss what physical activity is (with examples and reassurance)

Introduce the physical activity guidelines (assess group understanding)

Discuss and review activity levels (encourage participants to achieve recommended levels of physical activity)

Discuss the benefits of physical activity, and the different types of activity

Discuss the barriers to physical activity (and how to overcome them)

Signpost participants to further support if required (e.g. local access, GP referral, additional support) **OPTIONAL**

Activity diary (monitor awareness and reflection of physical activity undertaken, assess motivation to increase activity levels)

Goal setting (understanding of how goals can be achieved, encourage behaviour change, use goal setting tool)

Optional activity: walk or seated exercise (promote easy accessible form of physical activity)

Opportunity and encouragement for participant-led group discussion

**Diabetes patients only** Expectations from your health care professional (what to expect from your GP, practice nurse etc)

**Diabetes patients only** Annual Reviews (e.g. what is included? How often? What will happen?)

**Diabetes patients only** 15 Healthcare Essentials

Session 4: Positive mental health and wellbeing

Level of implementation

Notes

Low/Not observed

Observed to a small degree

Observed to a medium degree

High implementation

Friendly welcome

Refreshments offered (tea, coffee, water) ***OPTIONAL – Depends on location***

Recap previous week’s session (“Physical activity”)

Review activity diaries / progress (allow participants to raise concern over physical activity undertaken and guide them in making positive changes to their activity levels)

Opportunity for participants to ask questions

Assess retention from Session 3 (assess group and individual understanding, signpost for further support if required)

Assess importance and confidence to maintain healthy emotional wellbeing (encourage group interaction, motivation, and behaviour change)

Positive thinking (promote positive mental health and well-being)

Signpost if any mental health concerns are raised ***OPTIONAL***

Understand current feelings and thoughts about positive thinking

Discuss barriers to positive thinking

Relaxation techniques (demonstrate and encourage relaxation techniques to promote greater wellbeing)

Relaxation exercise ***OPTIONAL***

Review goals set (monitor goals set at the beginning/during the course, and discuss barriers if these have not been fulfilled)

Set new goals for future

Review all topics (ensure participants have relevant information for making positive lifestyle changes)

Signpost to local services if required (e.g. smoking cessation, health trainer, alcohol reduction) ***OPTIONAL***

Agree follow-up route (clear understanding of next steps and programme continuation)

Opportunity and encouragement for participant-led group discussion

Complete end of course questionnaire (course satisfaction data)

**Optional** Repeat clinical metrics

Notes: Items not highlighted are “adherence” criteria; items highlighted green are “competence” criteria; items highlighted grey are optional