title: Exploring the understanding of evidence-based concepts in people with type 2 diabetes.
abstract: BACKGROUND
  Being able to make informed decisions is a prerequisite to enabling individuals to participate actively in their health care. In turn, an individual's understanding of relevant health information can influence his/her ability to make informed decisions. However, there are two broad categories of health information, ie, background information (such as the pathophysiology of conditions) and foreground information (such as disease behavior, prognosis, and effects of treatment). Questions about foreground information are central to evidence-based practice. The majority of health literacy research has focused on background information, yet foreground information is more useful in decision-making, particularly for evidence-informed decisions. In people with type 2 diabetes, we explored individuals' knowledge of selected evidence-based concepts in diabetes; beliefs about what they can do to manage their diabetes and sources of this information; and whether these change after diabetes education.
  
  
  METHODS
  Attendees with type 2 diabetes (n = 95) at a one-day diabetes educational exposition completed a questionnaire before and after the event. We asked participants about evidence-based concepts in diabetes and compared their responses with the current evidence. We also asked participants how they could best manage their diabetes, and then, how they knew this.
  
  
  RESULTS
  Most participants underestimated their risk of complications. With the exception of a question about exercise and glycosylated hemoglobin level, nearly all participants provided responses that are not supported by current research evidence. There was no significant change in the percentage of participants who answered questions correctly after the exposition, except for a question about the risks of low blood glucose in which more participants answered incorrectly afterwards (P = 0.01). Health professionals were the most frequently identified source of information, with little value placed on research evidence.
  
  
  CONCLUSIONS
  Participants had a poor understanding of most of the evidence-based concepts in type 2 diabetes that were explored. This disadvantages them in being able to make informed decisions about their health care and actively manage their diabetes.
authors.affiliation: Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University ; School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Tammy C
authors.initials: TC
authors.lastname: Hoffmann
authors.forename: Chris B
authors.initials: CB
authors.lastname: Del Mar