Table 1 Examples of adaptation
EXTEND programme | Adapted Ghana programme | |
|---|---|---|
Language | English, Portuguese and Chichewa | English, Ga, Twi |
People | Trained educators were nurses and lay people with T2D | Trained educators were nurses and a doctor |
Programme was targeting adults with T2D from Malawi and Mozambique with low literacy levels | Programme was targeting adults with T2D from Ghana with low literacy levels | |
Metaphor | Lock and key analogy | Corn Mill analogy |
Chest of drawers analogy (to illustrate different groups of vegetables-starchy carbohydrate, vegetables, milk and milk products and fruit) | ||
Hats and shoes (to illustrate that carbohydrates have different amounts of sugars | ||
Content | Glucose story (carbohydrates turn into sugar) | Glucose story (carbohyrates are grinded down into sugar) |
Units in grams | Units counted in cedis (1 g equivalent to 1 cedi) | |
Quantity of oil using examples of oil | Quantity of oil using examples of water sachets (water in 1 sachet divided into 5. One portion used to represent 100 g of oil) | |
Examples of carbohydrate food used to illustrate key messages (i.e. rice pudding, cola, jam, yam raw, sweet potato) | Examples of carbohydrate food used to illustrate key messages (i.e. plantain varieties, kenkey, banku, fufu, yam varieties, rice, wheat, oats, gari, corn, sweet potato, bread) | |
Examples of physical activity examples (i.e. cycling, walking, cleaning house) | Examples of physical activity examples (i.e. hill climbing, aerobics, group street jogging “keep fit club” walking, hand washing, sweeping, cleaning house) | |
Examples of good/bad fats (i.e. soya, coconut oil) | Comparison of good/bad fats (i.e. olive, palm and coconut oil) | |
Diabetes self-management plan | Verbal discussions on concrete next steps and plans regarding diabetes self-management | |
Methods | Magnetic board with a human body outline and magnets of human organs | (when the magnetic board was unavailable) Large white boards with masking tape and marker pens |
Use of food models | Use of laminated images of local dishes | |
Attended in the morning, no breakfast offered | Attended in morning, breakfast offered | |
Self-management programme delivered in two 3-h sessions by two trained educators | Self-management programme delivered in one 5-h session by two trained educators | |
Facilitator training was delivered in person | Facilitator training was delivered virtually |