| Summary: | Background: Emotional support in type 2 diabetes (T2DM) is limited, however online-based programmes can be used as supplements for the emotional management of this condition. This research aimed to explore the emotional impact of T2DM and aimed to design a prototype of an evidence- and theory-based online programme to improve the emotional management of T2DM, especially well-being and diabetes-related distress. Methods: This thesis adopted a user-centered approach. A review of existing literature was undertaken to determine current concepts of well-being, diabetes-related distress (DRD) and stigma. A systematic review and meta-analysis were conducted to review the existing evidence on online-based interventions and well-being in T2DM. A secondary qualitative analysis was carried out to gain insight into the emotional impact of living with the condition. A series of patient and public involvement (PPI) and research advisory meetings were held regularly to inform early stages of the programme design. Focus groups were conducted with both people with T2DM (2 groups, n=10) and healthcare professionals (2 groups, n=10). The aim was to explore views living with T2DM, views on the use of the internet as a source for emotional support, and to evaluate the acceptability and feasibility of the online programme. All qualitative data in the methods section was analysed using framework analysis. Results: The systematic review and meta-analysis reported non-significant results for depression and DRD scores in online-based interventions, however these results were considered with caution. The secondary analysis identified key emotional challenges contributing to DRD. Overall, the qualitative studies reported a strong need for emotional support in T2DM; and verified the acceptability and feasibility of the online programme. Overall, information support, professional support and peer support were identified as important features for inclusion in an online emotional management programme. Discussion: Recommendations for clinical practice and further research are discussed in order to ensure future usability testing and effective implementation of the ‘My Well-being’ online programme.
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