title: Effectiveness of a health promotion programme for farmers and fishermen with type-2 diabetes in Taiwan.
abstract: OBJECTIVE
  This paper is a report of a study examining the diabetes control and foot self-care capability in farmers and fishermen following introduction of a multi-stage, multi-disciplinary team and community-based small group health promotion programme.
  
  
  BACKGROUND
  Improving the control of diabetes is a critical issue in Taiwan because mortality rates are increasing dramatically, particularly in rural populations.
  
  
  METHODS
  A quasi-experimental research design was deployed from January to December 2009. A total of 387 participants living in nine rural districts with previous diagnoses of type-2 diabetes were randomly selected. Three hundred and twenty-three completed the 3-stage programme, including health assessment, health promotion education and individually tailored telephone counselling and evaluation over a 1-year period.
  
  
  RESULTS
  Most of the participants were fishermen or farmers who had <6 years of education (79%) and were elders (68·9 ± 9·5 years). Most of the physiological variables and foot self-care capabilities showed statistically significant improvement after the programme. Furthermore, 37 participants with severe high risk of diabetic foot accepted additional referral treatments, and their peripheral nerve and vascular functions improved.
  
  
  CONCLUSIONS
  The research outcomes support the value of community-based health promotion programmes in rural areas, incorporating a multidisciplinary health team and culturally competent materials to help the elder rural inhabitants with diabetes enjoy better health and quality of life.
authors.affiliation: Chang Gung Institute of Technology, Chiayi Campus, Taiwan. meiyen@gw.cgit.edu.tw
authors.forename: Mei-Yen
authors.initials: MY
authors.lastname: Chen
authors.forename: Wei-Chao
authors.initials: WC
authors.lastname: Huang
authors.forename: Yun-Shing
authors.initials: YS
authors.lastname: Peng
authors.forename: Jing-Song
authors.initials: JS
authors.lastname: Guo
authors.forename: Chia-Pei
authors.initials: CP
authors.lastname: Chen
authors.forename: Ming-Chung
authors.initials: MC
authors.lastname: Jong
authors.forename: Hui-Chuan
authors.initials: HC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000383:Agriculture; D015331:Cohort Studies; D003153:Community Health Services / Q000458:organization & administration*; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D017719:Diabetic Foot / Q000517:prevention & control*; D005260:Female; D005398:Fisheries; D006293:Health Promotion / Q000379:methods* / Q000458:organization & administration; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D015397:Program Evaluation; D012424:Rural Population; D012648:Self Care / Q000379:methods; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome