title: Culturally sensitive patient-centred educational programme for self-management of type 2 diabetes: a randomized controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of a culturally sensitive, structured education programme (CSSEP) on biomedical, knowledge, attitude and practice measures among Arabs with type two diabetes.
  
  
  METHODS
  A total of 430 patients with type II diabetes mellitus living in Doha, Qatar were enrolled in the study. They were randomized to either intervention (n = 215) or a control group (n = 215). A baseline and one-year interval levels of biomedical variables including HbA1C, lipid profile, urine for microalbuminuria; in addition to knowledge, attitude and practice (KAP) scores were prospectively measured. The intervention was based on theory of empowerment, health belief models and was culturally sensitive in relation to language (Arabic), food habits and health beliefs. It consisted of four educational sessions for each group of patients (10-20 patients per session), lasting for 3-4 h. The first session discussed diabetes pathophysiology and complications; while the second session discussed healthy life style incorporating the Idaho plate method; and the third session dealt with exercise benefits and goal setting and the fourth session concentrated enhancing attitude and practice using counselling techniques. Outcomes were assessed at base line and 12 months after intervention.
  
  
  RESULTS
  After 12 months participation in the intervention was shown to have led to a statistically significant reduction in HbA1C in the (CSSEP) group (-0.55 mmol/L, P = 0.012), fasting blood sugar (-0.92 mmol/L, P = 0.022), body mass index (1.70, P = 0.001) and albumin/creatinine ratio (-3.09, P < 0.0001) but not in the control group. The intervention group also had improvement in Diabetes knowledge (5.9%, P < 0.0001), attitude (6.56%, P < 0.0001), and practice (6.52%, P = 0.0001).
  
  
  CONCLUSIONS
  This study demonstrates the effectiveness of culturally sensitive, structured, group-based diabetes education in enhancing biomedical and behavioural outcomes in Diabetic patients.
authors.affiliation: Weill Cornell Medical College - Qatar, Qatar; Family Medicine, Primary Health Care Corporation, P.O. Box 7452, Doha, Qatar. Electronic address: fmcc2000@gmail.com.
authors.forename: Hashim
authors.initials: H
authors.lastname: Mohamed
authors.forename: Badriya
authors.initials: B
authors.lastname: Al-Lenjawi
authors.forename: Paul
authors.initials: P
authors.lastname: Amuna
authors.forename: Francis
authors.initials: F
authors.lastname: Zotor
authors.forename: Hisham
authors.initials: H
authors.lastname: Elmahdi
mesh_terms: D000328:Adult; D000368:Aged; D018912:Arabs / Q000523:psychology*; D003376:Counseling; D003466:Cultural Characteristics; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D004032:Diet / Q000009:adverse effects / Q000208:ethnology; D015444:Exercise; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D006040:Goals; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011209:Power, Psychological; D011446:Prospective Studies; D011780:Qatar / Q000453:epidemiology; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012648:Self Care; D013997:Time Factors; D016896:Treatment Outcome
keywords: Effectiveness; Group-based diabetes education; Randomized controlled trial; Type 2 diabetes