Please take a read through the following key recommendations and consideration for cultural adaptations.

If you have any questions, or have undertaken similar work and would like to share this with other providers please email us on desmondnationalprogramme@uhl-tr.nhs.uk

Promoting DESMOND within ethnic minority groups

· Consider utilising promotional flyers in other languages e.g. short promotional flyers such as the examples provided here

· Consider accessing venues within the community that individuals from ethnic minority groups may frequently visit to promote DESMOND e.g. places of worship, community centres

· Consider accessing local events that may be aimed at specific communities to promote DESMOND.

· Consider trying to recruit a DESMOND community champion who can help promote DESMOND within their community

Course Access/Format/Structure

· Consider whether you need to hold groups specifically for ethnic minority groups or whether the DESMOND kit for face-to-face courses and virtual resources can be reviewed and adapted to meet the needs of your local population, making all your DESMOND courses inclusive.

· Consider whether virtual or face-to-face courses will be more appropriate to meet the needs of the community.

· Be mindful of delivering DESMOND face-to-face courses at venues that will be appropriate and accessible for the community.

· Be mindful of setting a maximum group size for the DESMOND course that will be comfortable for the group.

· Consider whether there’s a need for female/male only DESMOND groups that will be more appropriate to meet the needs of the community.

· Consider whether interpreters will be used or whether there could be an option to train Educators to deliver DESMOND who can speak the language.

· If using interpreters then the length of the course will need to be doubled due to the interpretation process e.g. 4 x 3-hour sessions or 2 x 6-hour sessions

Working with Interpreters

Course Preparation

· It’s beneficial to use the same interpreters consistently in order to maintain a good working relationship, and strive to make the participants feel more at ease, comfortable and able to contribute.

· Arrive in plenty of time so that you can meet with the interpreters and discuss any considerations beforehand.

· Check whether there are any personal ties between the interpreter and any participants in the group as this may affect how a participant engages in the session.

· Discuss whether there are any additional tasks you would like the interpreters to undertake while not interpreting, for example, writing on flipcharts in the target language or drawing images etc.

· Consider providing interpreters with information on the content of the DESMOND programme beforehand e.g. summary sheets for each of the sessions (key messages/content/resources used) alongside a glossary of terms within each of the sessions.

· Consider providing interpreters with information on the DESMOND programme to help ensure the interpreters remain congruent with the philosophy of the DESMOND course.

Course Structure/Timings

· Discuss with the interpreters prior to the start of the session which part of the curriculum will be delivered and where breaks are included in the timetable.

· Consider allowing extra time before the start of the DESMOND session for the interpreters and the group to meet. This is so they can familiarise themselves with their language styles.

Environment

· Ensure the participants are seated in a horseshoe as recommended within the DESMOND course.

· Ensure that participants have a clear view of your face and that the lighting in the room is good – this helps with when interpreters are present.

· Ensure that you don’t deliver from an area of the room where there is a window directly behind you as this will leave you and the interpreters as a silhouette.

· Ensure that you deliver from an area of the room where there are minimal visual distractions (no windows, sources of bright light or other visual distractions e.g. frequently used doors etc.) to allow participants to focus on the interpreters.

· Ensure that the interpreters are in hearing distance and ready before you start talking.

· Consider ways of reducing background noise e.g. air conditioning/heating, bleeps, alarms, traffic from open windows. Background noise might make interpreting difficult.

· Consider whether the interpreters are likely to need any resources, such as pens, for writing on flipcharts.

· Ensure that you don’t block the participant’s view of the flipchart/s or the interpreters when delivering.

· Use visuals where indicated throughout the DESMOND course to aid understanding.

Course Delivery

· Ensure you outline to participants within the introduction that interpreters work to a strict code of conduct that includes confidentiality.

· Consider whether there are any communication barriers between the participants and the Educators or participants and the interpreters due to gender differences.

· When using interpreters speak at a steady pace – too fast the interpreters may not be able to keep up. Too slow or waiting for the interpreters to catch up is not helpful as they may need a whole message before it can be translated.

· When using interpreters please ensure the conversation is directed to the participant and not to the interpreters or other family/friends that may be present.

· Be mindful of the potential for a delay between the original message and the interpreted message. This will be particularly relevant with the style of delivery used throughout the DESMOND course as participants are asked questions throughout and to provide comments. Ensure all participants are given the opportunity to respond if desired.

· Generate some ideas with the group within the introduction about how to work successfully together using interpreters e.g. explain that the interpreter may need to intervene if someone is speaking too fast or too quietly.

· Ask any relatives who speak English to let the interpreter do the interpreting rather than doing this for their relative as this might be very distracting for everyone in the group.

· Avoid moving around too much when delivering as this can distract the participant and interpreters.

· Be aware of verbal and non-verbal cues that may indicate that participants do not understand the interpretation and whether any clarification is needed.

Conclusion of Course

· Consider having a brief discussion with the interpreters to explore their views on what went well and any concerns or problems that were encountered in working together to deliver DESMOND.

· Consider completing a ‘DESMOND Reflection Sheet’ after the session.

Tailoring the DESMOND Course

Resources

· Consider using the culturally adapted versions of the Health Profile available here - Polish Health Profile/Action Plan, South Asian Health Profile/Action Plan and Health Profile/Action Plan for people from Black background all available.

· Consider still providing the DESMOND Participant Handbook in English as some groups may not read/write their own language and may instead prefer to seek support from a family member or friend who can translate content as and when needed.

· Consider obtaining packaging or purchasing products that are more culturally relevant to the group. Alternatively images included within the culturally adapted virtual resources on the DESMOND Embed portal can be printed and laminated for face-to-face groups.

· Consider asking participants to bring along their own products/packaging to face-to-face DESMOND courses (particularly if delivering across two half day sessions) or encourage participants to collect items from their cupboards to discuss if delivering virtually.

· Consider having information booklets available in other languages e.g. Diabetes UK have diabetes information in different languages and formats via the below link:

Diabetes information in different languages | Diabetes UK – hard copies of resources can be ordered free of charge.

Delivering & Promoting Culturally Adapted Groups