RESUMO
Workplace-based interprofessional education (IPE) offers opportunities for pre-registration students to interact with patients in authentic settings. Senior dietetic, medical, nursing, physiotherapy and radiation therapy students took part in a workplace IPE initiative on cancer and palliative care informed by experiential learning theory and run by clinical tutors. Research was undertaken to gauge students and tutors' experiences of the initiative. The mixed methods approach included: Pre and post-administration of the University of West England Interprofessional questionnaire 'Communication and Teamwork Scale, 'Interprofessional Learning Scale,' 'Interprofessional Interaction Scale.' Two questions were added relating to cancer and palliative care. Separate focus group interviews were held with students and tutors. There was a positive shift in the Communication and Teamwork scale based on students' pre and post questionnaires, but no change in the other two scales. Analysis of student and tutor focus group data showed that both affirmed the IPE initiative for a range of reasons. A brief experiential, theory-informed IPE initiative with a focus on cancer and palliative care was well received by both students and clinical tutors. The mixed method approach highlighted some discrepancies between quantitative and qualitative results but when synthesized were explicable, demonstrating the value of using a mixed methods approach to research.
Assuntos
Relações Interprofissionais , Neoplasias , Humanos , Cuidados Paliativos , Educação Interprofissional , Estudantes , Neoplasias/terapia , Local de Trabalho , Atitude do Pessoal de SaúdeRESUMO
Interprofessional education (IPE) programs for pre-registration health science students are largely offered within one institution including different schools or faculties. Sometimes in small or regional institutions where there are limited student numbers or few professional training programs, or where larger institutions do not offer particular professional programs, it may be necessary to partner with other institutions to offer IPE. This study sought to explore teacher perspectives of forming inter-institutional partnerships to deliver IPE, in particular, to identify the elements that influence the formation of partnerships. An interpretive descriptive approach was used to thematically analyze data from three focus groups with teachers (n = 21) working in three different partnerships to deliver IPE to students in Wellington, New Zealand. Two main themes were identified which enabled the development of a model of partnership, with a continuum of complexity depending on whether institutions were on the same page and whether the partnership formed to join an existing IPE program or to create a new IPE program. Forming inter-institution partnerships is a pragmatic solution to providing IPE with benefits to all taking part. Our work showed that time, effort, working with complexity, and ability to stay on the same page are necessary elements for building successful partnerships and all need to be taken into account when planning inter-institution partnerships.
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Docentes/psicologia , Ocupações em Saúde/educação , Relações Interinstitucionais , Educação Interprofissional , Adulto , Comportamento Cooperativo , Feminino , Grupos Focais , Humanos , Relações Interprofissionais , Masculino , Nova ZelândiaRESUMO
Most doctors working in New Zealand general practice undertake vocational training through the Royal New Zealand College of General Practitioners. We aimed to explore general practice registrar views on their academic learning needs during and following vocational training. An online survey of all current NZ GP trainees in 2019 was completed by 314 registrars (54% response rate). The majority (88%, 275/314) were completing RNZCGP Fellowship only, and of these half (55%, 152/275) were planning a further postgraduate qualification. A minority (12%, 33/275) indicated a desire to undertake a masters or PhD degree. Almost all (99%, 310/314) intended to work in general practice; 9% (8/314) intending to also work as rural hospital doctors. The five most common areas of interest for further training were clinical skills (68%), practice-based teaching (66%), specific clinical conditions (63%), age or life-stage specific (47%) and non-clinical areas (41%). There is a considerable gap between completing RNZCGP Fellowship, intending to undertake further (formal postgraduate) education and actually enrolling. This is concerning given the need for lifelong learning and critical evaluation of practice and health service delivery. The future New Zealand general practice workforce needs GPs to be diverse and highly skilled members or leaders of expert teams.
Assuntos
Educação de Pós-Graduação em Medicina/métodos , Clínicos Gerais/educação , Internato e Residência , Adulto , Bolsas de Estudo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Inquéritos e QuestionáriosRESUMO
In New Zealand undergraduate health professional degrees focus on aspects of indigenous (Maori) health. Formal and informal feedback suggests that for individual students the impact of those components in respect of Maori health varies. Separate and sequential interprofessional groups of students from seven health professions participated in an innovative and immersive Interprofessional programme. All participating students had prior exposure during their respective degrees to theoretical perspectives of indigenous health. At the end of each and every 5-week long programme each cohort of student contributed to a focus group discussion. Analysis revealed that for these groups of students the real-life exposure to an indigenous community was positively regarded and, in some instances, transformative. The students also reported that the 'lived' experience in an indigenous community built upon and in many cases extended prior learning of indigenous health. Whilst the results are encouraging it must be noted that the students who were exposed to this experience represented less than 10% of the entire student population. It is clear that a key challenge for us is to enable more students to be exposed to this powerful learning experience.
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Competência Cultural , Ocupações em Saúde/educação , Serviços de Saúde do Indígena/organização & administração , Estudantes de Ciências da Saúde/psicologia , Grupos Focais , Humanos , Relações Interprofissionais , Havaiano Nativo ou Outro Ilhéu do Pacífico , Nova Zelândia , Percepção , Aprendizagem Baseada em Problemas , Pesquisa QualitativaRESUMO
It is important to understand what an interprofessional education (IPE) experience means to students and what makes it meaningful so that optimal use can be made of IPE opportunities and resources. This article reports qualitative data from a larger study evaluating an 11-hour IPE programme which focused on long-term condition management. Qualitative analysis aimed to explore students' perspectives of the programme. Forty-one students from dietetics, medicine, physiotherapy, and radiation therapy were invited to participate in interprofessional focus groups. Data gathered from 34 students who participated in two focus groups were analysed inductively using thematic analysis. Three key themes emerged related to (i) learning, (ii) perceived long-term professional benefits, and (iii) the structure and content of the programme. Participants considered the programme to be a valuable learning opportunity with direct relevance to their future clinical careers. Findings indicated that providing students with an opportunity to learn about each other should be prioritised within IPE programmes and that this process should be student-led. This may help students to effectively learn with and from each other. Students perceived active learning activities, including interviewing a patient in their home and presenting findings to their peers, to be particularly valuable.
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Atitude do Pessoal de Saúde , Comportamento Cooperativo , Pessoal de Saúde/educação , Relações Interprofissionais , Estudantes de Ciências da Saúde/psicologia , Adulto , Feminino , Grupos Focais , Humanos , Aprendizagem , Masculino , Nova Zelândia , Equipe de Assistência ao Paciente/organização & administração , Adulto JovemRESUMO
BACKGROUND: Collaborative interprofessional practice is an important means of providing effective care to people with complex health problems. Interprofessional education (IPE) is assumed to enhance interprofessional practice despite challenges to demonstrate its efficacy. This study evaluated whether an IPE programme changed students' attitudes to interprofessional teams and interprofessional learning, students' self-reported effectiveness as a team member, and students' perceived ability to manage long-term conditions. METHODS: A prospective controlled trial evaluated an eleven-hour IPE programme focused on long-term conditions' management. Pre-registration students from the disciplines of dietetics (n = 9), medicine (n = 36), physiotherapy (n = 12), and radiation therapy (n = 26) were allocated to either an intervention group (n = 41) who received the IPE program or a control group (n = 42) who continued with their usual discipline specific curriculum. Outcome measures were the Attitudes Toward Health Care Teams Scale (ATHCTS), Readiness for Interprofessional Learning Scale (RIPLS), the Team Skills Scale (TSS), and the Long-Term Condition Management Scale (LTCMS). Analysis of covariance compared mean post-intervention scale scores adjusted for baseline scores. RESULTS: Mean post-intervention attitude scores (all on a five-point scale) were significantly higher in the intervention group than the control group for all scales. The mean difference for the ATHCTS was 0.17 (95 %CI 0.05 to 0.30; p = 0.006), for the RIPLS was 0.30 (95 %CI 0.16 to 0.43; p < 0.001), for the TSS was 0.71 (95 %CI 0.49 to 0.92; p < 0.001), and for the LTCMS was 0.75 (95 %CI 0.56 to 0.94; p < 0.001). The mean effect of the intervention was similar for students from the two larger disciplinary sub-groups of medicine and radiation therapy. CONCLUSIONS: An eleven-hour IPE programme resulted in improved attitudes towards interprofessional teams and interprofessional learning, as well as self-reported ability to function within an interprofessional team, and self-reported confidence, knowledge, and ability to manage people with long-term conditions. These findings indicate that a brief intervention such as this can have immediate positive effects and contribute to the development of health professionals who are ready to collaborate with others to improve patient outcomes.
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Atitude do Pessoal de Saúde , Doença Crônica/terapia , Comportamento Cooperativo , Currículo , Relações Interprofissionais , Equipe de Assistência ao Paciente , Papel do Médico/psicologia , Estudantes de Ciências da Saúde/psicologia , Estudantes de Medicina/psicologia , Terapia Combinada , Feminino , Humanos , Masculino , Nova Zelândia , Estudos Prospectivos , Adulto JovemRESUMO
As part of a clinically based rotational undergraduate interprofessional programme, an assessment was devised which was construed as being socially accountable. An interprofessional programme, with cohorts of students from six different health professions, was evaluated in a number of ways. Students completed pre and post questionnaires about many aspects of the programme and also participated in focus groups. The social accountability of the key assignment emerged as important for both students and the community agencies that provided the clinical experience for students. Students implicitly and explicitly reported that their awareness of the need for health professionals to be socially accountable was heightened as a result of the assignment task. This article indicates that with creativity and perseverance an assessment can be devised that is relevant both to the student and the community, and is a powerful learning exercise for all involved.
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Serviços de Saúde Comunitária , Ocupações em Saúde/normas , Pessoal de Saúde/educação , Relações Interprofissionais , Área de Atuação Profissional , Responsabilidade Social , HumanosRESUMO
BACKGROUND: This article presents findings from a prospective, longitudinal cohort educational study investigating empathy communication in clinical consultations. It reports on changes in students' self-report empathy during medical undergraduate training, investigates how well peers can assess student competence in motivational interviewing/brief interventions (MI/BI) skills and explores the relationship between students' self-report empathy and peer- or tutor-assessments of competence. METHODS: 72 medical students completed the Jefferson Scale of Physician Empathy at three time points: at the beginning of their fifth year medical training (Time 1), after a specific MI/BI training session during their fifth year medical training (Time 2) and 1 year later during a revision session in year 6. Competence in BI/MI consultation was assessed using the validated tool Behaviour Change Counselling Index. RESULTS: A significant decline in medical students' empathy scores was observed from year 5 to year 6, consistent with international findings. Peer assessments and tutor ratings of competence in MI/BI skills performance were moderately correlated, but peer assessments were negatively correlated with medical students' self-rated empathy. Senior medical students who self-rated as more empathic received lower competence evaluations of MI/BI skills from their peers. Interventions to further investigate teaching and learning of empathy are discussed.
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Educação de Graduação em Medicina , Empatia , Estudantes de Medicina/psicologia , Feminino , Humanos , Masculino , Estudos Prospectivos , Autorrelato , Fatores de TempoRESUMO
Introduction Pre-registration interprofessional rural immersion programmes provide students with first-hand insight into challenges faced in rural clinical practice and can influence future practice intentions. The impact of short rural and hauora Maori interdisciplinary placements on early healthcare careers is unknown. Aim Explore whether a 5-week rural interprofessional education programme influenced graduates' choices to work in primary care, rurally, and with Maori patients. Methods We conducted a survey-based, non-randomised trial of graduates from eight healthcare disciplines who did (n = 132) and did not (n = 479) attend the Tairawhiti interprofessional education rural programme with hauora Maori placements. Participants were surveyed at 1-, 2-, and 3-years' post-registration. Self-reported practice location and vocation were analysed with mixed-model logistic regression. Free-text comments were analysed with Template Analysis. Results We did not identify any measurable impact on rural or community workforce participation at 3-years' post-registration. Free-text analysis indicated that a short rural interprofessional immersion placement had long-term self-perceived impacts on desire and skills to work in rural locations, and on desire and ability to work with Maori and embrace Maori models of health. Discussion Our study suggests that short rural immersion placements do not increase rural workforce participation during early healthcare careers. Three-years' post-graduation may be too early to determine whether rural placements help to address rural health workforce needs. Reports from rural placement participants of increased ability to care for people from rural backgrounds, even when encountered in a city, suggest that assessment of practice location may not adequately capture the benefits of rural placement programmes.
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Mão de Obra em Saúde , Serviços de Saúde Rural , Humanos , Escolha da Profissão , Educação Interprofissional , Povo Maori , Atenção Primária à SaúdeRESUMO
Type 2 diabetes (T2DM), its related morbidities and entrenched diabetes-related inequities pose significant challenges for health care delivery systems in Aotearoa New Zealand (NZ). Primary care services undertake the majority of diabetes prevention work by initially detecting and managing those with prediabetes. In this viewpoint, we present available NZ data to highlight NZ trends in prediabetes and consider the current NZ clinical guidelines and the prediabetes care pathway. Multiple areas for improvement are identified to optimise diabetes prevention, potentially reduce T2DM inequities, and sustain more effective prediabetes management in primary care in NZ.
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Diabetes Mellitus Tipo 2 , Estado Pré-Diabético , Humanos , Estado Pré-Diabético/terapia , Estado Pré-Diabético/diagnóstico , Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/diagnóstico , Nova Zelândia/epidemiologia , Atenção à Saúde , Atenção Primária à SaúdeRESUMO
Introduction Type 2 diabetes mellitus (T2DM) is a highly prevalent and potentially preventable condition associated with significant health, social, and economic costs. The detection and management of pre-diabetes is an important opportunity to prevent or delay the onset of T2DM and associated morbidities; however, its importance is controversial as the health risks associated with pre-diabetes are poorly understood. Aim To understand the cardio-metabolic health profile of a sample of adults with pre-diabetes in Aotearoa New Zealand. Methods Secondary analyses of baseline data from all 153 adults recruited to an intervention trial for adults with pre-diabetes were carried out. A profile of cardio-metabolic risk was measured by describing the proportion with metabolic syndrome (MetS) calculated using Adult Treatment Panel III criteria, which includes blood pressure, lipids, and obesity in addition to glycaemic measures. The severity of MetS was calculated as MetS Z-scores. Subgroup analyses for sex, ethnicity and glycated haemoglobin (HbA1c ) were performed. Results Overall, 74% of this study population had MetS, and the proportion varied according to ethnicity and HbA1c level. The severity of MetS was highly variable, with MetS-Z-scores ranging from -1.0 to 2.8. Although mean MetS Z-scores differed according to ethnicity and HbA1c level, all subgroups included individuals with widely differing severity of MetS, suggesting likely quite different risks for progression to diabetes or cardiovascular disease across the range of pre-diabetes defined by HbA1c . Discussion Single biochemical markers of glycaemia are insufficient to ascertain overall cardio-metabolic risk when prioritising clinical efforts for those with pre-diabetes, particularly in primary care, where the potential for preventing or delaying the onset of type 2 diabetes mellitus (T2DM) is significant. Findings indicate the importance of attending to all cardio-metabolic risk factors when caring for people with pre-diabetes. The development of tools using multiple relevant variables and predicting a comprehensive range of outcomes would improve timely risk stratification and treatment effect monitoring of pre-diabetes populations.
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Diabetes Mellitus Tipo 2 , Síndrome Metabólica , Estado Pré-Diabético , Adulto , Biomarcadores , Glicemia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Hemoglobinas Glicadas , Humanos , Lipídeos , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Nova Zelândia/epidemiologia , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/terapia , Fatores de RiscoRESUMO
OBJECTIVE: To assess whether a preregistration interprofessional education (IPE) programme changed attitudes towards teamwork and team skills during health professionals' final year of training and first 3 years of professional practice. DESIGN: Prospective, longitudinal, non-randomised trial. SETTING: Final year health professional training at three academic institutions in New Zealand. PARTICIPANTS: Students from eight disciplines eligible to attend the IPE programme were recruited (617/730) prior to their final year of training. 130 participants attended the IPE programme; 115 intervention and 372 control participants were included in outcome analysis. INTERVENTION: The 5-week Tairawhiti IPE (TIPE) immersion programme during which students experience clinical placements in interdisciplinary teams, complete collaborative tasks and live together in shared accommodation. MAIN OUTCOME MEASURES: Data were collected via five surveys at 12-month intervals, containing Attitudes Towards Healthcare Teams Scale (ATHCTS), Team Skills Scale (TSS) and free-text items. Mixed-model analysis of covariance, adjusting for baseline characteristics, compared scores between groups at each time point. Template analysis identified themes in free-text data. RESULTS: Mean ATHCTS scores for TIPE participants were 1.4 (95% CI 0.6 to 2.3) points higher than non-TIPE participants (p=0.002); scores were 1.9 (95% CI 0.8 to 3.0) points higher at graduation and 1.1 (95% CI -0.1 to 2.4) points higher 3 years postgraduation. Mean TSS scores for TIPE participants were 1.7 (95% CI 0.0 to 3.3) points higher than non-TIPE participants (p=0.045); scores were 3.5 points (95% CI 1.5 to 5.5) higher at graduation and 1.3 (95%CI -0.8 to 3.5) points higher 3 years postgraduation. TIPE participants made substantially more free-text comments about benefits of interprofessional collaboration and perceived the TIPE programme had a meaningful influence on their readiness to work in teams and the way in which they performed their healthcare roles. CONCLUSIONS: TIPE programme participation significantly improved attitudes towards healthcare teams and these changes were maintained over 4 years.
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Educação Interprofissional , Relações Interprofissionais , Pessoal de Saúde/educação , Humanos , Equipe de Assistência ao Paciente , Estudos ProspectivosRESUMO
Introduction Prediabetes is the asymptomatic precursor to type two diabetes mellitus, a significant and growing public health problem in New Zealand (NZ). Little is known about how general practitioners (GPs) and nurses view prediabetes care, and similarly little is known about how people with prediabetes view their condition and care. Aim This study aimed to investigate the views of NZ GPs and nurses, and people with prediabetes about prediabetes and its management. Methods This was a mixed qualitative methods study that is part of a randomised control trial of a prediabetes intervention. Results Three key themes emerged from the health professional data (GPs and nurses) and another three themes emerged from people with prediabetes data. GPs and nurses were uncertain about the progression of prediabetes; they felt prediabetes was not a priority and they were unsure about what to advise. People with prediabetes were uncertain about the diagnosis and information given to them; they were unsure about what to do about prediabetes and they found lifestyle change hard. Discussion GPs, nurses and people with prediabetes, expressed much uncertainty, but also some certainty about prediabetes. All were certain that prediabetes is common and increasing and that sustained lifestyle change was very difficult. But uncertainty prevailed about whether, in reality, prediabetes could be stopped, who would be most likely to benefit from lifestyle interventions and how best to achieve these. Older Maori and Pacific women were keen to promote lifestyle change and this appeared best done through Maori and Pacific peoples' organisations by means of co-designed interventions.
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Estado Pré-Diabético , Feminino , Humanos , Nova Zelândia , Atenção Primária à Saúde , Pesquisa Qualitativa , IncertezaRESUMO
INTRODUCTION Youth health outcomes are poor in New Zealand and have a life-long impact on individuals, whanau (family) and society. Little is known about how young people view their experiences of general practice care despite it being the most common place to access health care. AIM This study sought to explore young peoples' experiences of care in a selected, youth-friendly general practice. METHODS In-depth individual interviews with six young people. RESULTS Four themes were identified from young peoples' narratives in relation to their experiences of general practice care: going to the doctor is not easy for a young person; the attributes of staff make all the difference; specific youth-friendly consultation practices help young people; and a youth-friendly physical environment can help young people access services and feel safe. DISCUSSION Even though the study general practice had explicitly instituted youth-friendly initiatives, including offering no-charge consultations and specialist staff members, young people still described considerable barriers to attendance. Many barriers are practice-based and could be modified by staff training, provision of further youth care staff roles and consideration of environmental changes. Other barriers such as waiving prescription costs need government funding.
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Medicina Geral , Adolescente , Atenção à Saúde , Emoções , Medicina de Família e Comunidade , Humanos , Nova ZelândiaRESUMO
BACKGROUND AND CONTEXT Globally, the coronavirus disease 2019 (COVID-19) pandemic has highlighted the need for better interprofessional collaboration and teamwork. When disciplines have worked together to undertake testing, deliver care and administer vaccines, progress against COVID-19 has been made. Yet, teamwork has often not happened, wasting precious resources and stretching health-care workforces. Continuing to train health professionals during the pandemic is challenging, particularly delivering interprofessional education that often uses face-to-face delivery methods to optimise interactional learning. Yet, continuing to offer interprofessional education throughout the pandemic is critical to ensure a collaboration-ready health workforce. One example is continuing the established INVOLVE (Interprofessional Visits to Learn Interprofessional Values through Patient Experience) interprofessional education initiative. ASSESSMENT OF PROBLEM Educators have not always prioritised interprofessional education during the pandemic, despite its immediate and long-term benefits. The INVOLVE interprofessional education initiative, usually delivered face-to-face, was at risk of cancellation. RESULTS A quality improvement analysis of the strategies used to continue INVOLVE demonstrated that it is possible to deliver interprofessional education within the constraints of a pandemic by using innovative online and hybrid educational strategies. Educators and students demonstrated flexibility in responding to the sudden changes in teaching and learning modalities. STRATEGIES When pandemic alert levels change, interprofessional educators and administrators can now choose from a repertoire of teaching approaches. LESSONS Four key lessons have improved the performance and resilience of INVOLVE: hold the vision to continue interprofessional education; be nimble; use technology appropriately; and there will be silver linings and unexpected benefits to the changes.
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COVID-19 , Pessoal de Saúde/educação , Humanos , Educação Interprofissional , Relações Interprofissionais , Pandemias/prevenção & controle , SARS-CoV-2RESUMO
Despite an ever-increasing burden of non-communicable diseases and overwhelming evidence that good nutrition improves outcomes it is difficult to know whether this evidence is reaching the general population. The purpose of this study was to investigate whether health professionals in Tairawhiti have sufficient nutrition education for their roles in health education and promotion and whether nutrition beliefs held by health professionals were consistent with current literature. A particular interest was to enlist views on the harms, benefits, and possible barriers to following plant-based diets. A mixed-methods study involving health professionals completing a questionnaire and a subsequent focus group to collect data was used. Survey data were analysed using spreadsheet software, and thematic content analysis of focus group data was undertaken. Participants provided nutrition advice 2.4 times per day. Almost half of practitioners considered their nutrition knowledge to be inadequate, and most made poor use of references for provision of information. Plant-based diets were generally viewed as beneficial to health, improve quality of life, be filling, but were perceived as not as easy to follow. This study is in keeping with previous research that the health workforce would benefit from more formalised nutrition education and competencies to address common chronic disease.
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Dieta , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Coleta de Dados , Feminino , Humanos , Masculino , Nova Zelândia , Fenômenos Fisiológicos da Nutrição , Qualidade de VidaRESUMO
INTRODUCTION: More men than women live with overweight and obesity in New Zealand, yet we know little about their everyday lives or their weight management experiences in primary care. This study sought to link the weight management experiences of these men in primary care, with their experiences of life in general as big men. METHODS: Semi-structured interviews with participants selected purposively based on a priori criteria were conducted. Interviews were either face to face or via telephone. Interviews were digitally recorded and transcribed and text coded into a priori codes where established. RESULTS: Fourteen men were interviewed. Analysis of text data revealed three overarching themes. The first, social experience of life as a big man highlighted the significance of social transitions as times of weight gain. The second theme related to experiences of weight management in primary care, with communication the largest sub-theme. Finally, stigma materialised as a key and widespread issue. CONCLUSION: Scant attention has been paid to the experiences of overweight and obese men in primary care or the impact of their size on their daily lives. Effective, tailored communication by health professionals in primary care is sorely needed. Times of social transition can be exploited as appropriate instances to offer advice on effective strategies to reduce the risk of weight gain. Men also need to be made aware of their vulnerability for weight gain at these times through effective, gender specific health promotion messages. The widespread nature of stigmatising experiences within personal networks was a concerning finding.
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Medicina Geral , Obesidade/psicologia , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Preferência do Paciente , Saúde da População Rural , Estereotipagem , Saúde da População Urbana , Adulto JovemRESUMO
BACKGROUND: The rates of pre-diabetes and type 2 diabetes mellitus are increasing worldwide, producing significant burdens for individuals, families, and healthcare systems. In New Zealand, type 2 diabetes mellitus and pre-diabetes disproportionally affect Maori, Pacific, and South Asian peoples. This research evaluates the efficacy, acceptability, and economic impact of a probiotic capsule and a prebiotic cereal intervention in adults with pre-diabetes on metabolic and mental health and well-being outcomes. METHODS: Eligible adults (n = 152) aged 18-80 years with pre-diabetes (glycated haemoglobin 41-49 mmol/mol) will be enrolled in a 2 × 2 factorial design, randomised, parallel-group, placebo-controlled trial. Computer-generated block randomization will be performed independently. Interventions are capsulated Lactobacillus rhamnosus HN001 (6 × 109 colony-forming units/day) (A) and cereal containing 4 g ß-glucan (B), placebo capsules (O1), and calorie-matched control cereal (O2). Eligible participants will receive 6 months intervention in the following groups: AB, AO1, BO2, and O1O2. The primary outcome is glycated haemoglobin after 6 months. Follow-up at 9 months will assess the durability of response. Secondary outcomes are glycated haemoglobin after 3 and 9 months, fasting glucose, insulin resistance, blood pressure, body weight, body mass index, and blood lipid levels. General well-being and quality of life will be measured by the Short-Form Health Survey 36 and Depression Anxiety Stress Scale 21 at 6 and 9 months. Outcome assessors will be blind to capsule allocation. An accompanying qualitative study will include 24 face-to-face semistructured interviews with an ethnically balanced sample from the ß-glucan arms at 2 months, participant focus groups at 6 months, and three health professional focus groups. These will explore how interventions are adopted, their acceptability, and elicit factors that may support the uptake of interventions. A simulation model of the pre-diabetic New Zealand population will be used to estimate the likely impact in quality-adjusted life years and health system costs of the interventions if rolled out in New Zealand. DISCUSSION: This study will examine the efficacy of interventions in a population with pre-diabetes. Qualitative components provide rich description of views on the interventions. When combined with the economic analysis, the study will provide insights into how to translate the interventions into practice. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12617000990325. Prospectively registered on 10 July 2017.