title: A comparison of two methods of foot health education: the Fremantle Diabetes Study Phase II.
abstract: OBJECTIVE
  To compare the effectiveness of two different methods of education on foot health, behaviours and attitudes in patients with type 2 diabetes.
  
  
  METHODS
  Community-based patients were consecutively allocated to written education (Group A) or an interactive educator-led session (Group B). A quantitative Foot Score (maximum 90 points score based on severity of treatable pathology), the Nottingham Assessment of Functional Foot Care (NAFFC) survey score (maximum 30 points reflecting frequency of foot care behaviours) and a 6-question survey of attitudes to foot complications were administered at baseline and 3 months.
  
  
  RESULTS
  154 patients (mean±SD age 68±10 years, 59.7% males, median [interquartile range] diabetes duration 11.5 [5.6-18.9] years) were recruited. There was a greater change (Δ) in Foot Score from baseline to 3 months in Group A (8.3±3.6, Δ-1.8 (95% CI: -2.4 to -1.2) vs Group B (6.8±2.6, Δ-0.1 (-0.7 to 0.4); P<0.001), but no change in NAFFC survey score in either group (P=0.13). In the attitudes survey, Group B felt they better understood how to prevent foot complications than Group A after education (P=0.031).
  
  
  CONCLUSIONS
  Written information was more effective at improving foot health while interactive education improved confidence in undertaking preventive measures, suggesting that the most effective foot care education should include both components.
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia; Podiatric Medicine Unit, University of Western Australia, Crawley, Perth, Western Australia, Australia.
authors.forename: Mendel
authors.initials: M
authors.lastname: Baba
authors.affiliation: Diabetes WA, Subiaco, Western Australia, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Duff
authors.affiliation: Podiatric Medicine Unit, University of Western Australia, Crawley, Perth, Western Australia, Australia.
authors.forename: Laurie
authors.initials: L
authors.lastname: Foley
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia.
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Davis
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia. Electronic address: tim.davis@uwa.edu.au.
authors.forename: Timothy M E
authors.initials: TM
authors.lastname: Davis
mesh_terms: D000368:Aged; D057186:Comparative Effectiveness Research; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D017719:Diabetic Foot / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D014904:Western Australia
keywords: Education; Foot health; Intervention; Type 2 diabetes