Table 1.

Phases of the study and data collected

Phase		Goals	Main actions	Data sources
1	Set-up	Map the extent of diabetes and level of diabetes care in the locality; develop partnerships with key stakeholders; link our own work to existing healthcare and community development initiatives	Collect statistics on burden of disease and nature and extent of services for diabetes (NHS and voluntary sector); interviews with 35 people representing 13 organisations (hospitals, general practices, interpreting organisations, voluntary sector ethnic health groups)	Publicly available epidemiological data (for example, from local health improvement plan); published details of local services (such as information supplied to general practitioners); field notes from visits to stakeholder organisations; interview notes
2	Learning set for BHAs	Train a cohort of BHAs in the principles of diabetes care and in running support and education groups for clients with diabetes	Assess the background and experience of BHAs and their perceived training needs and learning styles; run two “taster” education sessions for BHAs, using interactive exercises with “Post-it” notes to identify and classify learning needs; develop and deliver a curriculum in a format appropriate to these needs	Semistructured (qualitative) interviews with seven NHS managers and two voluntary sector advocacy services; self completion questionnaire sent to 21 BHAs to assess knowledge, experience, and perceived leaming needs (before and after the training course) (18 returned); participant observation in “taster” group sessions; Post-it notes and flipchart paper from these sessions; focus group evaluation of learning set led by independent qualitative researcher
3	On-site work with BHAs	Support BHAs to pilot diabetes groups for clients in their workplace	Work at organisational level to tackle human resource problems for BHAs (job description, level of autonomy, lines of accountability); support BHAs, their managers, and the wider organisation in establishing pilot groups and embed them in services	Ethnographic field notes from organisational visits; interviews with advocacy services managers; interviews with other diabetes staff (consultants, specialist nurses)
4	Diabetes groups for service users	Set up and sustain BHA led education and support groups for diabetes service users	Support BHAs in recruiting participants to groups, running the groups, engaging other health professionals in providing educational input, and evaluating the groups	Quantitative data on attendance, random blood glucose levels (measured by finger prick testing during the group); qualitative data: participant observation of all sessions plus one focus group of attenders during routine lunchtime session, led by NB; tape recorded, translated, and transcribed with consent

BHA=bilingual health advocates.