ACT Now! Guided self-help for adults with Type 2 diabetes to improve self-management and emotional wellbeing


A team in NHS Grampian developed a brief, guided self-help programme designed to improve glycaemic control and alleviate anxiety and depression in people struggling to manage type 2 diabetes. ACT Now! consists of between 5-8 appointments, a participant manual and web-based support. The web support incorporates five core modules that promote key self-management behaviours, and three optional modules for those experiencing significant levels of anxiety, depression, or emotionally-driven eating. All modules contain a mixture of video, audio and text material that aim to reinforce weekly discussion topics, provide patient stories, and deliver top tips from experts in the topic areas. Results showed improvement in all areas for participants, including glycaemic control, and anxiety and depression levels fell significantly from baseline to follow-up, as did diabetes-related distress. Participants increased their walking markedly.


Despite regular appointments and good quality education, about half of people with type 2 diabetes do not achieve recommended levels of glycaemic control. Markedly changing complex, long-established lifestyle behaviours that influence glycaemic control and health outcomes, and adhering to treatment regimens that may induce significant side effects can be extremely challenging. Clinical and subclinical anxiety and depression are common, and are associated with poorer glycaemic control. Research indicates that treating anxiety and depression alone does not lead to better diabetes control. Prior to this project there were not any specific guided self-help programmes available for people with Type 2 diabetes in NHS Grampian, or across the UK.


To create an intervention that consisted of a small number of 1:1 appointments, a participant and therapist manual, and a web-based resource. To engage a number of primary care practices and the local specialist diabetes outpatient service. To recruit 30 people with type 2 diabetes who meet pre-specified criteria.

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QiC Diabetes Highly Commended 2016
Empowering People with Diabetes – Adults
ACT Now! Guided self-help for adults with Type 2 diabetes to improve self-management and emotional wellbeing
by NHS Grampian


Dr Andrew Keen

Job title:
Consultant Health Psychologist
Place of work:
NHS Grampian
01224 550139

Quality In Care Diabetes

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  • 2022 KEY DATES
  • Open for entry:
    Monday 28 March 2022
  • Entry Deadline:
    Friday 1 July 2022
  • Judging day:
    Tuesday 6 September 2022
  • Awards ceremony:
    Thursday 13 October 2022