The Empowerment Ladder: Understanding transition across leadership stages in individuals with type 1 diabetes and other noncommunicable diseases

Abstract

Background: Acceptance and adjustment to lifelong noncommunicable diseases (NCDs) pose a great challenge for individuals living with these conditions. Diabetes is one of the most prevalent NCDs, with type 1 diabetes usually diagnosed during childhood. Self-leadership is linked to internal and external factors that may motivate individuals with NCDs to play an active role as changemakers in their community or society. The Young Leaders in Diabetes (YLD) training, created to equip young people with skills that would benefit the population to which they belong, uses the Empowerment Ladder as a framework to identify their position relative to three leadership stages (self, community and society). Objective: To describe the stages and the ‘climbing’ process of the Empowerment Ladder and assess its suitability as a framework for use in a leadership training context. Method: From among 29 youth leaders who participated, 15 were selected (5 men and 10 women) and had their community engagement and activity analysed before and after training. Individuals were positioned on the Empowerment Ladder according to their past and current roles and activities. The difference between pre- and post-training test grades (delta scores) was calculated. Results: Post-training scores were significantly higher than pre-training scores (8.9 ± 0.54 vs 7.6 ± 1.08, p = .00084). Most individuals moved to a higher step on the Empowerment Ladder; however, three individuals, with delta scores lower than the median (0.1, 0.15 and 0.85) remained at their pre-YLD training level. Only one individual moved from Stage 1 (self) to Stage 3 (society). Another individual occupied two different steps at Stages 1 and 2 simultaneously because, although they demonstrated community leadership, they had not yet accepted their own health condition. Conclusion: The Empowerment Ladder proved a useful tool for identifying stages from self to broader levels of leadership in individuals living with type 1 diabetes. These initial findings need to be validated with a larger population, which includes other NCD groups.

Oral Health Knowledge and Habits of People With Type 1 and Type 2 Diabetes

“…Trained diabetes advocates could be core messengers. 23 However, some people did not receive professional dental care, particularly edentulous individuals.…”

Meaningful Engagement of People Living With Noncommunicable Diseases: Challenges and Opportunities

“…Hence, it is of crucial importance to upskill these groups with the necessary tools and training for effective advocacy, ensuring they understand how and when to participate. 3 , 6 , 7 , 11 This practice, already adopted by some national and international organizations, helps to prevent tokenistic and superficial involvement. 3 , 6 Leadership courses, training programs, and workshops can significantly contribute to preparing participants, and enhancing their confidence and commitment.…”

“…3 , 6 Leadership courses, training programs, and workshops can significantly contribute to preparing participants, and enhancing their confidence and commitment. 6 , 11 These initiatives can also aid providers or decision-makers by offering training that mitigates their skepticism and fosters an environment conducive to effective participation and advocacy. 6 …”