Shared Medical Appointments for Type 2 Diabetes

The intervention is a programmed Shared Medical Appointment program (pSMAs) with mindfulness.The intervention involves six 2 hour pSMAs, delivered at Western Sydney Integrative Health by a GP, facilitator (allied health professional), documenter and a meditation teacher. The overall duration and frequency of the program is six fortnightly pSMAs. Educational content will include: • Overall management of diabetes and importance of lifestyle modifications; • Healthy eating for diabetes and weight loss; • Physical activity; • Exploring and overcoming barriers to lifestyle changes; and • Supporting psychological wellbeing. Participants are encouraged to set their own lifestyle goals based on the RACGP handbook on General Practice Management of Type 2 Diabetes. Key goals will include weight loss of 5%, as improvements in weight have a significant impact on glycaemic control. The mindfulness component will be delivered by an experienced meditation teacher and will consist of 15-20 minutes of guided mindfulness meditation and informed by previous RCTs on mindfulness for weight loss. The pSMAs will be complemented by a workbook for reference and recording goals, and home mindfulness practice exercises. Typically, SMAs involve 10-12 participants per group. The schedule for pSMAs follows: Introduction and warm-up (facilitator only):5-10 minutes; Structured educational session (facilitator and allied health professional): 30 minutes; Mindfulness component: 15-20 minutes Individual GP consultations: 50-60 minutes. 10-12 individual GP consultations will be conducted over 50-60 minutes with about 5 minutes consultation per participant, in a group setting.Participants ask questions of the GP that they would ask of any GP during a medical consultation about their diabetes. This may include: interpretation of blood test results and physical examination findings; questions about medications; lifestyle advice; management of stress. For the home mindfulness practice, there is no prescribed time but participants are sent a weekly reminder and are encouraged to meditate as per their preference. A daily meditation is suggested but the duration is up to the participant.