title: Effectiveness of PRECEDE model for health education on changes and level of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  Individual health education is considered to be essential in the overall care of patients with type 2 diabetes (DM2), although there is some uncertainty regarding its metabolic control benefits. There have been very few randomized studies on the effects of individual education on normal care in DM2 patients with a control group, and none of these have assessed the long-term results. Therefore, this study aims to use this design to assess the effectiveness of the PRECEDE (Predisposing, Reinforcing, Enabling, Causes in Educational Diagnosis, and Evaluation) education model in the metabolic control and the reduction of cardiovascular risk factors, in patients with type 2 diabetes.
  
  
  METHODS
  An open community effectiveness study was carried out in 8 urban community health centers in the North-East Madrid Urban Area (Spain). Six hundred patients with DM2 were randomized in two groups: PRECEDE or conventional model for health promotion education. The main outcome measures were glycated hemoglobin A1c, body mass index (BMI), blood pressure, lipids and control criteria during the 2-year follow-up period.
  
  
  RESULTS
  Glycated hemoglobin A1c and systolic blood pressure (SBP) levels decreased significantly in the PRECEDE group (multivariate analysis of covariance, with baseline glycated hemoglobin A1c, SBP, and variables showing statistically significant differences between groups at baseline visits). The decrease levels in diastolic blood pressure (DBP), triglycerides and LDL cholesterol were nonsignificant. PRECEDE increased compliance in all control criteria, except for LDL cholesterol. BMI did not change during the study in either of the two models analyzed.
  
  
  CONCLUSIONS
  PRECEDE health education model is a useful method in the overall treatment in patients with type 2 diabetes, which contributes to decrease glycated hemoglobin A1c and SBP levels and increase the compliance in all the control criteria, except for LDL cholesterol.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01316367.
authors.affiliation: Fundación Investigación Biomédica, Hospital Carlos III, SERMAS, Madrid, Spain. miguel.salinero@salud.madrid.org
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Salinero-Fort
authors.forename: Enrique
authors.initials: E
authors.lastname: Carrillo-de Santa Pau
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Arrieta-Blanco
authors.forename: Juan C
authors.initials: JC
authors.lastname: Abanades-Herranz
authors.forename: Carmen
authors.initials: C
authors.lastname: Martín-Madrazo
authors.forename: Berta
authors.initials: B
authors.lastname: Rodés-Soldevila
authors.forename: Carmen
authors.initials: C
authors.lastname: de Burgos-Lunar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation; D012648:Self Care; D013030:Spain
chemical_list: D006442:Glycated Hemoglobin; D008055:Lipids