Co-designing Multimedia Messages and Resources to Reduce Diabetes-Related Stigma and Promote Healthcare Engagement in Women with Type 2 Diabetes

Background Type 2 diabetes (T2D) is increasing rapidly in younger populations and is associated with a more aggressive disease trajectory accelerating cardiovascular, renal and eye complications. Despite these risks, younger individuals with T2D are less likely to engage in or receive routine diabetes care. Evidence shows that stigma has a significant inhibitory impact on health-seeking behaviours in this population. Women with T2D face significant stigma, often rooted in the misconception that T2D is self-induced due to poor lifestyle behaviours. Stigma, whether experienced or perceived, adversely affects women s psychological wellbeing (shame, guilt, distress), health-seeking behaviours, self-management activation, and engagement with reproductive and pregnancy care, which is of particular importance in diabetes. These challenges contribute to poorer short- and long-term physical and mental health outcomes. The growing prevalence of T2D among younger women and their challenges engaging with care highlight an urgent need for targeted anti-stigma interventions. This study will develop co-designed multimedia resources aimed at reducing stigma and improving healthcare interactions, empowering women with T2D and fostering positive healthcare experiences. Aim and Objectives Aim: To co-design multimedia anti-stigma interventions (films/animations, messages and education for healthcare professionals (HCPs)) with women with T2D, their partners/families, and HCPs to mitigate stigma. Objectives: 1. Identify the triggers and narratives of stigma impacting women with T2D. 2. Develop a framework for targeted anti-stigma interventions and messaging. 3. Design multimedia tools to foster supportive healthcare interactions, address self-stigma and empower patients. Methods The study is divided into two integrated work packages (WPs): Work Package 1 (WP1): Stigma Exploration and Modelling (Months 1–8) 1. Stigma Modelling: we will use data from a previous study with women with T2D to identify stigma-related themes, modelling them into a preliminary framework using an established theory-based stigma model. 2. Intervention Framework Development: we will conduct focus groups with women, their partners, families, and HCPs to explore behavioural and contextual drivers of stigma. These findings will shape the anti-stigma interventions and messages. Work Package 2 (WP2): Intervention Development (Months 9–15) We will translate WP1 findings into multimedia resources targeting stigma triggers. Stakeholder sessions will refine and prioritise messages, develop and finalise resources for dissemination. Timelines for Delivery Months 1–8: Conduct WP1, including stigma modelling, interaction groups, and data analysis. Months 9–13: Complete WP2, developing, finalising and validating multimedia resources. Month 13-15: Prepare and execute dissemination strategy, including launch event and conference presentations. Anticipated Impact and Dissemination The multimedia resources will address stigma in healthcare and other settings where it is identified, fostering empathetic interactions between women with T2D and HCPs. These interventions are expected to improve women s engagement with diabetes care, self-management activation and mental wellbeing, and reduce stigma by improving communication with and messages from HCPs. Dissemination efforts will target women with T2D, their families and friends, HCPs, and wider society. Findings and resources will be shared in healthcare settings, through academic publications, conferences, and online platforms. Collaborations with patients, community organisations, NHS networks, and professional bodies will ensure broad reach and impact.