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Tools and Interventions

Detecting diabetes-related comorbidity and multimorbidity in BAME patients can sometimes be challenging for physicians, partly because BAME adults may engage less with health services due to cultural factors, or perceived racism. We support the development of new tools or methods that can help diagnose, predict, and reduce comorbidity and multimorbidity in BAME diabetes patients. We are particularly keen to support interventions that can be adapted to cultural (e.g. language) needs, and administered in a non-clinical setting, in order to reach patients reluctant to engage with the health service.

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Important guidance for researchers

a) Research proposals for developing or evaluating tools/interventions must be based on extensive and systematic reviews of the scientific literature, and purport to advance existing knowledge (i.e. make an original contribution). 

b) Research proposals must, if possible, adhere to guidelines for developing, conducting and reporting medical research, specifically PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses), CONSORT (Consolidated Standards of Reporting Trials) and STROBE (Strengthening the Reporting of Observational Studies in Epidemiology).

c) We support the development of tools/interventions based entirely on current or proposed systematic reviews of existing literature, provided such reviews strictly adhere to PRISMA, which guides the reporting of systematic reviews and meta-analyses.

d) We prioritise randomised controlled trials, or prospective cohort studies (rather than say cross-sectional designs, or qualitative research) when making evaluations about which tools/interventions should be developed. However, such evidence must have clearly adhered to CONSORT (Consolidated Standards of Reporting Trials) or STROBE (Strengthening the Reporting of Observational Studies in Epidemiology).

e) Mixed-methods research (i.e. combining both qualitative and quantitative elements) will also be considered, provided the qualitative element explores experiential factors specific to the BAME community.

 f) Diversity in research is a priority. Participants in current or future research supported by the trust must reflect the diversity of our culture and conditions, taking into account race and ethnicity. Lack of diversity will impede our ability to generalise study results, and prevent the BAME community from experiencing the benefits of research innovations.

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Suitable interventions

The tools and interventions primarily involve diagnostic testing (to detect or predict multimorbidity), and may relate to laboratory medicine, anatomic pathology, and medical imaging. There are others forms of diagnostic testing that extend beyond medicine and clinical science, such as psychometric instruments (e.g. questionnaires) used in diagnosing mental illness (e.g. anxiety and depression).

 The following points should be noted:

a) All intervention projects must first be approved by an NHS Research Ethics Committee (REC), before receiving any funding from the trust.

b) All projects must adhere to UK Policy Framework, with particular attention given to Principle 1 (Safety), and Principle 8 (Benefits and Risks).

c) The safety/suitability of an intervention must be established before a project begins, consistent with Principle 8 of the Policy Framework (Benefits and Risks): ‘Before the research project is started, any anticipated benefit for the individual participant and other present and future recipients of the health or social care in question is weighed against the foreseeable risks and inconveniences once they have been mitigated’.

d) A separate risk assessment must be completed by the Principal Investigator (PI), before the project begins.

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Monitoring

a) The use of tools/interventions by patients will only happen in the context of a research project undertaking by a qualified clinical research team, monitored by a Steering Group.

b) We do not support the use of tools/interventions used by patients, without medical supervision, unless this has been approved before hand by NHS ethics.

 c) The board of trustees views monitoring of patients as integral to Principle 19 (‘Duty of Care’) of the Policy Framework.

d) The board of trustees will require that each project is overseen by a designated mentor, who will confer regularly with the Principal Investigator and clinical research team, to discuss and review the monitoring of patients.

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