Creating a Stigma-Free Clinic

A checklist to help create a welcoming and supportive environment for every person who walks in

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Providing the best care for people with diabetes means making sure that they feel welcome, supported, comfortable, and understood at every healthcare appointment they have. However, the physical environment and the equipment used throughout a healthcare visit can sometimes contribute to stigma.

Here’s a checklist to help you set up a stigma-free clinic.

Remove or replace materials, posters, pamphlets, and other things that employ fear-based or stigmatizing messaging and imagery.

  • Examples of what these might look like include:
    • Materials with faceless body parts portraying people of size or people with disabilities or experiencing diabetes-related complications
    • Materials that equate diabetes, simplistically, with junk food, sugar, weight, and/or laziness
    • Materials that use loss-framing techniques, which describe a choice or outcome based on its negative features. When used in the context of diabetes, this type of framing often focuses on describing a negative outcome that comes as a result of not changing a behavior (“If you don’t eat right, you will get diabetes-related complications”) as opposed to gain-framing (“By exercising for 30 minutes a day, you can promote heart health”)
    • Materials that focus on scaring people with their risk for diabetes-related complications in order to motivate them to make behavior changes.

Make sure materials represent the diversity of individuals who may enter the clinic including race, gender, disability, age, and size.

Make sure all seating is size-inclusive. Avoid chairs, stools, or benches that would be uncomfortable or unusable for people with a larger body.

Make sure all medical equipment is size-inclusive.

  • Examples include:
    • Medical gowns
    • Arm pressure cuffs
    • Imaging and diagnostic equipment, such as MRI machines
    • Scales
    • Exam tables

Make sure your office is set up to allow for privacy when taking vitals and other measurements, such as weight, height, and blood pressure.

Make sure that your office is set up to accommodate, and has policies for assisting, people who may be affected by diabetes-related complications. This includes people who may have visual or hearing impairments, people who may have prosthetics, people who may use a walker or other mobility device, etc.

Make sure your office has necessary supplies for someone who may experience an acute episode of hypoglycemia or hyperglycemia. For example, having glucose tablets or emergency glucagon on site (as allowed), and making sure staff are trained to help in an emergency situation.

Include resources for internal or external behavioral health services geared towards people with diabetes, when possible.

Make sure you and your colleagues are trained on how to speak up when stigmatizing comments, language, or behaviors are used.

This resource was created for dStigmatize, a diaTribe Foundation program, with support from Lilly Diabetes, AstraZeneca, and the Boehringer Ingelheim-Lilly Alliance.

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Boehringer Ingelheim and Lilly Alliance