{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T06:23:48Z","timestamp":1787207028046,"version":"build-2736575974"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Health Serv."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Individuals with serious mental illness (SMI), such as schizophrenia or bipolar disorder, are at a two- to threefold increased risk of developing type 2 diabetes and face significant health inequalities, including reduced life expectancy. Diabetes self-management in this population is challenging, and existing interventions are poorly suited to their needs. Continuous glucose monitoring (CGM) offers potential benefits but remains underused. This study aimed to co-design a logic model and programme theory for a structured CGM intervention tailored to adults with SMI and type 2 diabetes, as a resource to support the planned future co-production of the content and the implementation of the full intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using experience-based co-design, this study engaged service users, carers, and healthcare professionals (HCPs) in workshops and discussions to identify challenges and facilitators for CGM use. Participants co-developed an outline of candidate intervention components, which were summarised in a logic model and programme theory. The process included synthesising existing evidence, exploring personas, and mapping CGM user journeys. The draft intervention outline was iteratively refined across multiple sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten participants (four HCPs, four service users, and two carers) contributed to the co-design process. Barriers identified included limited technical support, accessibility challenges, and a lack of integrated physical and mental healthcare. Key components for a structured CGM intervention include personalised CGM training, flexible delivery methods, ongoing support, and peer networks. The proposed intervention was conceptualised in three phases: set-up, early days, and living with CGM. Participants prioritised flexibility and tailored intervention adjustments, emphasising the importance of addressing both physical and mental health needs concurrently.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study demonstrates the feasibility of co-designing interventions with individuals often considered \u201chard to reach.\u201d Our study highlights that people with SMI can take an interest in their physical health and see the potential for CGM to improve diabetes management, provided they receive appropriate and flexible support. Future work will develop and refine the intervention and evaluate its clinical and cost-effectiveness in diverse populations, aiming to address significant unmet needs in diabetes care for this vulnerable group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/osf.io\/4ae3g\/<\/jats:ext-link>\n                      (2 February 2024).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frhs.2026.1807689","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T05:28:12Z","timestamp":1787203692000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Supporting continuous glucose monitoring for people with serious mental illness and type 2 diabetes: a co-design study for a structured intervention"],"prefix":"10.3389","volume":"6","author":[{"given":"Jennifer V. E.","family":"Brown","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Faculty of Sciences, University of York","place":["York, United Kingdom"]},{"name":"School of Medicine and Population Health, Faculty of Health, University of Sheffield","place":["Sheffield, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Matthias","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Sciences, University of York","place":["York, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Hendon","sequence":"additional","affiliation":[{"name":"Hendon Creative","place":["York, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramzi A.","family":"Ajjan","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Diabetes Research, School of Medicine, University of Leeds","place":["Leeds, United Kingdom"]},{"name":"Leeds Teaching Hospitals NHS Trust","place":["Leeds, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najma","family":"Siddiqi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Sciences, University of York","place":["York, United Kingdom"]},{"name":"Hull York Medical School","place":["York, United Kingdom"]},{"name":"Bradford District Care NHS Foundation Trust","place":["Bradford, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Kellar","sequence":"additional","affiliation":[{"name":"School of Psychology, Faculty of Science, University of Sheffield","place":["Sheffield, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"Coventry","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Sciences, University of York","place":["York, United Kingdom"]},{"name":"School of Nursing and Public Health, Faculty of Health and Education, Manchester Metropolitan University","place":["Manchester, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.eurpsy.2009.01.005","article-title":"Cardiovascular disease and diabetes in people with severe mental illness. 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