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Aims: The DAFNEplus programme seeks to promote sustained improvements in glycaemic management by incorporating techniques from behavioural science. It includes five sessions of structured individual support delivered over 12 months following group education. As part of a broader evaluation, and to inform decision‐making about roll‐out in routine care, we explored participants' experiences of, and engagement with, that individual support. Methods: We interviewed DAFNEplus participants (n = 28) about their experiences of receiving individual support and the impact they perceived it as having on their self management practices. We analysed data thematically. Results: Participants described several important ways individual support had helped strengthen their self management, including: consolidating and expanding their understandings of flexible intensive insulin therapy; promoting ongoing review and refinement of behaviour; encouraging continued and effective use of data; and facilitating access to help from healthcare professionals to pre‐empt or resolve emergent difficulties. Participants characterised themselves as moving towards independence in self management over the time they received individual support, with their accounts suggesting three key stages in that journey: 'Working with healthcare professionals'; 'Growing sense of responsibility'; and, 'Taking control'. Whilst all portrayed themselves as changed, participants' progress through those stages varied; a few continued to depend heavily on DAFNEplus facilitators for advice and/or direction at 12 months. Conclusions: While all participants benefited from individual support, our findings suggest that some may need, or gain further benefit from, longer‐term, tailored support. This has important implications for decision‐making about roll‐out of DAFNEplus post‐trial and for the development of future programmes seeking to bring about sustainable changes in self management practices. [ABSTRACT FROM AUTHOR]

Prompted by changing demographics, economic pressures, and global competition, Texas and members of the Southern Regional Education Board adopted policies to boost minority enrollment and success in higher education around the turn of the century. This study draws upon IPEDS graduation rate data for a benchmark year, 2002, and for 2006 through 2012 to assess the effectiveness of Texas' Closing the Gaps policy in relation to graduation rates at 4- year institutions and to similar policies in six SREB-member states. Descriptive and independent-samples "t" tests measured the effectiveness of Texas' Closing the Gaps compared to the selected SREB states. Although Texas fell below the SREB average graduation rates for targeted groups at the outset, data revealed variable but overall improvement for the grand total, Black, Hispanic, and White cohorts over the 10-year period for all states.

This study measured the effectiveness of and differences between Oklahoma's Brain Gain and Texas' Closing the Gaps policies to enhance degree completion of students at community colleges. Descriptive statistics and independent-samples "t" tests were conducted utilizing data from community colleges' 3-year graduation rates from the National Center for Education Statistics Integrated Postsecondary Education Data Systems database for benchmark year 2002 and years 2006, 2008, 2010 and 2012. The results showed that both states' total, black, and white community college 3-year graduation rates decreased from 2002 to 2012. Only Oklahoma's Hispanic graduation rate increased while Texas' Hispanic graduation rate decreased during the same period. No statistically significant differences were found between total, Black, Hispanic, and White community college graduation rates in Oklahoma and Texas. Findings revealed that the policies implemented in Oklahoma and Texas did not cause the desired impact at their states' community colleges. Recommendations for policy and future research are provided.

Aims: The DAFNEplus programme incorporates behaviour change techniques into a modified educational intervention and was developed to help address the glycaemic drift observed amongst graduates of standard DAFNE programmes. As the programme's success will be contingent on staff buy‐in, we explored healthcare professionals' experiences of, and views about, delivering DAFNEplus during a clinical trial to help inform decision making about rollout post‐trial. Methods: We interviewed n = 18 nurses and dieticians who delivered DAFNEplus during the trial. Data were analysed thematically. Results: While many shared initial reservations, all described how their experiences of DAFNEplus programme delivery had had a positive, transformative impact upon their perceptions and working practices. This transformation was enabled by initial training and supervision sessions, the confidence gained from using scripts to support novel programme content delivery, and experiences of delivering the programme and observing DAFNEplus principles being well received by, and having a positive impact on, attendees. Due to these positive experiences, interviewees described a strongly felt ethical mandate to use some DAFNEplus techniques and curriculum content in routine clinical care. While being supportive of a national rollout, they anticipated a variety of attitudinal and logistical (e.g. workload) challenges. Conclusions: This study provides a vital dimension to the evaluation of the DAFNEplus programme. Interviewees found the intervention to be acceptable and expressed high levels of buy‐in. As well as offering potential endorsement for a national rollout, our findings offer insights which could help inform development and rollout of future behaviour change interventions to support diabetes self‐management. [ABSTRACT FROM AUTHOR]

Aims: As part of a broader process evaluation, we explored participants' experiences of, and engagement with, the DAFNEplus programme's group‐based structured education course. This course, which was informed by behavioural science, provided participants with education and instruction to use flexible intensive insulin therapy (FIIT) together with techniques to identify and address unhelpful cognitive and emotional influences on their type 1 diabetes self‐management. Methods: We interviewed n = 28 DAFNEplus participants. Data were analysed thematically and took account of previous work exploring individuals' experiences of standard DAFNE courses. Results: As well as benefitting from the DAFNEplus course's skills‐based training and educational curriculum, participants' accounts suggested they had experienced cognitive and emotional changes that had positively influenced their confidence and motivation to adopt and sustain the use of FIIT. These benefits were most keenly felt by those who reported negative emotional states and mind‐sets pre‐course which had made their diabetes self‐management challenging. Participants' cognitive and emotional changes were enabled through techniques used during the course to normalise setbacks and imperfect diabetes self‐management, capitalise upon group synergies and encourage the use of social support, including from healthcare professionals. Participants also highlighted motivational gains arising from being reassured that diabetes complications are not common or inevitable if a FIIT regimen is followed. Conclusions: Our findings suggest that offering training in FIIT, in conjunction with behaviour change techniques that target unhelpful mindsets and emotional resilience, may be more effective in promoting diabetes self‐management than offering education and skills training alone. [ABSTRACT FROM AUTHOR]