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Alaofè H, Mahdavimanshadi M, Mizéhoun-Adissoda C, Okechukwu A, Hounkpatin WA, Bedrick EJ, Gninkoun J, Fan N, Ehiri J. Precision nutrition for type 2 diabetes in Benin: leveraging linear goal programming to optimize diets with emphasis on adequacy, affordability, accessibility, and culture. Front Nutr 2024; 11:1400594. [PMID: 39176027 PMCID: PMC11338894 DOI: 10.3389/fnut.2024.1400594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/18/2024] [Indexed: 08/24/2024] Open
Abstract
Background Nutrition and diet are critical to managing Type 2 diabetes (T2D). Low-income households often face challenges maintaining a healthy and balanced diet due to food insecurity, availability, and cost. To address this issue, we used a linear goal programming (LGP) model to develop nutritionally adequate, affordable, accessible, and culturally acceptable diets for persons with T2D in Benin, a French-speaking sub-Saharan country. The goal was to help persons with T2D manage their condition more effectively. Methods We compiled a robust list of local commonly consumed foods in Benin, and calculated their nutritional value using West African food composition tables and food costs per serving from a market survey. Using mathematical optimization techniques, we designed dietary plans that meet the daily nutrient intake recommended by the World Health Organization (WHO) to prevent chronic diseases in normal adults. While adhering to dietary constraints of T2D, we developed optimized diet plans with varying energy levels that meet all nutrient requirements while considering availability, acceptability, and budgetary constraints. Results Fifty-two food items and recipes were evaluated to create six low-cost daily menus. Menu 1 was the most affordable at CFA 1,127 (USD 1.88), providing 1890 kcal of energy, while Menu 6 was the most expensive at CFA 1,227 (USD 2.05), providing 1749 kcal. All the menus met the daily WHO minimum requirements for carbohydrates, fat, cholesterol, and fiber content, while other nutrients such as protein, vitamin C, and iron reached the upper limits of the acceptable value range. Conclusion Linear goal programming can be an effective tool in helping to obtain optimized adequate, accessible, and culturally acceptable diets at minimal cost by interpreting and translating dietary recommendations into a nutritional model, based on local market prices.
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Affiliation(s)
- Halimatou Alaofè
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Mahdi Mahdavimanshadi
- Department of Systems and Industrial Engineering, University of Arizona, Tucson, AZ, United States
| | - Carmelle Mizéhoun-Adissoda
- School of Nutrition and Dietetics, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Abidemi Okechukwu
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Waliou Amoussa Hounkpatin
- School of Nutrition and Food Science and Technology, Faculty of Agricultural Sciences of the University of Abomey-Calavi, Calavi, Benin
| | - Edward John Bedrick
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Jules Gninkoun
- Faculty of Health Sciences, University of Abomey Calavi, Cotonou, Benin
| | - Neng Fan
- Department of Systems and Industrial Engineering, University of Arizona, Tucson, AZ, United States
| | - John Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
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Al-Wagdi BE, Al-Hanawi MK. Knowledge, attitude and practice toward diabetes among the public in the Kingdom of Saudi Arabia: a cross-sectional study. Front Public Health 2024; 12:1326675. [PMID: 38694982 PMCID: PMC11061416 DOI: 10.3389/fpubh.2024.1326675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/01/2024] [Indexed: 05/04/2024] Open
Abstract
Background The increasing adoption of sedentary lifestyles and cultural shifts has fostered unhealthy habits and decreased physical activity, consequently exacerbating the prevalence of diabetes. Diabetes is currently one of the top 10 diseases worldwide, contributing significantly to both mortality and morbidity. Since diabetes hinges on self-care, possessing the right knowledge, attitude, and habits related to the disease is paramount. This study, therefore, aims to examine the knowledge, attitude, and practice of diabetes among the population of Saudi Arabia. Methods The study utilized data from a cross-sectional study conducted via an online self-reported questionnaire among the general population of Saudi Arabia. The study primarily used univariate and multivariable regression data analyses. Univariate analysis was employed to compile social and demographic statistics frequencies, while One-way analysis of variance (ANOVA) was used to assess mean differences in knowledge, attitudes, and practices scores. Furthermore, a multivariable linear regression analysis was executed to identify factors associated with knowledge, attitudes, and practices. Results The mean score for diabetes knowledge was 17.79 (SD = 5.39, range: 0-29), with an overall accuracy rate of 61.34%. The mean attitude score for diabetes was 2.33 (SD = 1.91, range: 0-7), while the mean score for diabetes practices was 2.58 (SD = 1.28, range: 0-4). The multivariate analyses reveal distinct variations in knowledge, attitudes, and practices of diabetes among participants based on their gender, education, marital status, income, diabetes patient status, and having a medical field-related education. Conclusion High knowledge scores do not necessarily equate to positive attitudes and practices related to diabetes. There is need for intensified care and the implementation of specialized educational programs that emphasize the importance of having the right attitude and engaging in the good diabetes practices.
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Affiliation(s)
- Bashayer Ebraheem Al-Wagdi
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
- Physical Therapy Department, Ahad Rafidah General Hospital, Abha, Saudi Arabia
| | - Mohammed Khaled Al-Hanawi
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
- Health Economics Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
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Zegeye MY, Yosef T, Asres A. Prevalence of Diabetes and Associated Factors Among Government Employees of Mizan-Aman Town and Zonal Sector Office, Bench Sheko Zone, Southwest Ethiopia Region, 2022. Diabetes Metab Syndr Obes 2024; 17:725-738. [PMID: 38371387 PMCID: PMC10870931 DOI: 10.2147/dmso.s444487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction Diabetes mellitus (DM) is a serious non-communicable disease (NCD) that represents a major health and development challenge of the 21st century. Ethiopia is the leading country among the top five high-burden African countries for the number of people with diabetes. To address problems within the population, it is important to assess the prevalence of diabetes and identify the risk factors associated with its diagnosis. Objective The study aims to determine the prevalence of diabetes and identify its associated factors among office workers of Mizan-Aman Town administration and Bench Sheko Zone Sector Office. Methods A sector office-based cross-sectional study was conducted on 559 randomly selected employees of Mizan Aman Town Administration and Zonal Office from June 5 to June 30, 2022. Fasting plasma glucose was tested, and the result ≥126 mg/dL was used to diagnose DM. Data were entered using Epi Data version 4.0.2 and exported to the Statistical Package for the Social Sciences (SPSS version 26) for analysis. Bivariate analyses were included in the multivariable model with p <0.25. Adjusted odds ratios (AOR) with a confidence interval (CI) of 95% are reported, with a significance level of p < 0.05. Results The overall prevalence of Diabetes was 9.4% with 95%CI(7.1,12.1)). Among the participants,60.8% were men, 58.2% of workers were aged 40 years or older, and the mean age was 39.7 ± 9.9 years. Having hypertension (AOR 3.85, 95% CI (1.7,7.4), family history of diabetes (AOR 4.5, 95% CI (1.2, 15.8), physical inactivity defined as failure to participate in moderate intensity activities at work, sitting ≥180 minutes per day (AOR = 3.57, 95% CI (1.1, 11.0)) and having central obesity AOR: 3.25, 95% CI (1.5, 6.7) independently associated with higher odds of DM. However, those having good knowledge of DM (AOR=0.26, 95% CI: (0.10, 0.6)) and consuming fruits and vegetables greater than five servings per week (AOR=0.32 95% CI (0.1, 0.7)) predicted lower odds of DM. Conclusions and Recommendations The prevalence of DM among office workers was high and is associated with lifestyle, family history, dietary practices, and knowledge about DM. Therefore, arranging regular screening programs at the workplace and promotion of healthy diet, exercise, and awareness creation are needed to lower the prevalence.
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Affiliation(s)
- Mesfin Yimam Zegeye
- Department of EMT, Mizan Aman Health Science College, Mizan Aman Town, Southwest Ethiopia Regional State, Ethiopia
| | - Tewodros Yosef
- Public Health Department, Mizan Tepi University, Mizan Aman Town, Southwest Ethiopia Regional State, Ethiopia
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Australia
| | - Abyot Asres
- Public Health Department, Mizan Tepi University, Mizan Aman Town, Southwest Ethiopia Regional State, Ethiopia
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Alenbalu M, Egenasi CK, Steinberg WJ, Aluko O. Diabetes Knowledge, Attitudes, and Practices in adults with type 2 diabetes at primary health care clinics in Kimberley South Africa. S Afr Fam Pract (2004) 2024; 66:e1-e9. [PMID: 38299524 PMCID: PMC10839212 DOI: 10.4102/safp.v66i1.5838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is a common non-communicable disease associated with significant morbidity and mortality globally. It poses a huge public health and economic challenge. People with diabetes need to have adequate knowledge, attitudes and practice (KAP) to prevent complications from diabetes. This study aims to evaluate the KAP towards diabetes among type 2 diabetes mellitus (T2DM) patients attending primary healthcare clinics in Kimberley. METHODS A cross-sectional analytical, quantitative questionnaire-based study was done using a convenient sampling method in Sol Plaatje Municipality, Kimberley, Northern Cape. RESULTS A total of 363 type 2 diabetic patients took part in the study. Most of the participants (62.0%) were females. Most had good knowledge (67.5%), while 64.5% of the participants showed good attitudes towards diabetes. However, only 35.8% of the participants had good practices towards diabetes. There was a significant association between the participant's level of education and (1) knowledge and (2) practice, with p-values of 0.002 and 0.0075, respectively. No significant association was found between the participant's level of education and attitudes towards diabetes (p = 0.2416). CONCLUSION This study demonstrated good diabetes-related knowledge and attitudes but inadequate practices among participants. Educational programmes to assist patients with diabetes to improve their practice towards diabetes should be encouraged and implemented.Contribution: This study will help to create awareness of the need for people with diabetes to improve their practices towards diabetes.
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Affiliation(s)
- Moses Alenbalu
- Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein.
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Joho AA, Sandi F, Yahaya JJ. Determinants of knowledge, attitude, and practice among patients with type 2 diabetes mellitus: A cross-sectional multicenter study in Tanzania. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001351. [PMID: 38039284 PMCID: PMC10691713 DOI: 10.1371/journal.pgph.0001351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 10/31/2023] [Indexed: 12/03/2023]
Abstract
Improvement of primary care for patients with type 2 diabetes mellitus (T2DM) through the promotion of good knowledge, attitude, and practice is of paramount importance for preventing its related complications. This study aimed to assess the levels of knowledge, attitude, and practice and associated factors among patients with T2DM. This was a cross-sectional multicenter hospital-based study that included 979 patients from 8 health facilities in Tanzania. A standardized semi-structured interviewer-administered questionnaire was used to extract the required data. Factor analysis was used to determine the level of knowledge, attitude, and practice. Multivariable analysis under binary logistic regression analysis was used to determine the predictors of knowledge, attitude, and practice. P<0.05 was considered significant. The levels of adequate knowledge, positive attitude, and appropriate practice were 62.1%, 54%, and 30.9%, respectively. Being self-employed (AOR = 1.74, 95% CI = 0.28-0.91, p = 0.040) predicted adequate knowledge. Being male (AOR = 1.46, 95% CI = 1.06-2.01, p = 0.021 and visiting regional hospitals (AOR = 2.17, 95% CI = 1.33-2.51, p = 0.013) were predictors of positive attitude. Residing in rural areas and not having adequate knowledge of diabetes were less likely associated with appropriate practice. This study has shown a significantly low level of appropriate practice among patients with T2DM towards general issues on diabetes, risk factors, and related complications. Therefore, emphasis should be placed on improving good practices that can help prevent related complications.
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Affiliation(s)
- Angelina A. Joho
- Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania
| | - Frank Sandi
- Department of Ophthalmology, School of Medicine and Dentistry, The University of Dodoma, Dodoma, Tanzania
| | - James J. Yahaya
- Department of Pathology, School of Health Sciences, Soroti University, Soroti, Uganda
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Zhu W, Liang D, Petersen JD, Zhang W, Huang J, Dong Y. Relationship between diabetic knowledge, attitudes and practices among patients with diabetes in China: a structural equation model. BMJ Open 2023; 13:e076464. [PMID: 37973542 PMCID: PMC10660206 DOI: 10.1136/bmjopen-2023-076464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES Whether the routine delivery of diabetes-related knowledge can change patients' attitudes and hence influence their self-management activities remains unknown in primary healthcare settings in China. Thus, this study aims to explore the complex transformation process between knowledge, attitude and practice (KAP) among patients with diabetes in a city in China. DESIGN A cross-sectional study. SETTING Yuhuan City, Zhejiang Province, China. PARTICIPANTS A total of 803 patients with diabetes were invited to attend a questionnaire survey and 782 patients with type 2 diabetes completed the survey. The average age of participants was 58.47 years old, 48.21% of whom only attended primary school or below. PRIMARY AND SECONDARY OUTCOME MEASURES A questionnaire based on existing scales and expert consultation was applied to assess patients' socio-demographic information (SI), disease progression risk and diabetes-related KAP. A structural equation model was built to analyse the relationships between patients' characteristics and KAP. RESULTS No significant association was found between patients' knowledge and attitude (β=0.01, p=0.43). Better knowledge and attitude were both found to be associated with better diet and physical activities (β=0.58, p<0.001; β=0.46, p=0.01). However, patients with a more positive attitude toward diabetic care showed worse foot care practice (β=-0.13, p=0.02), while better knowledge was associated with better foot care practice (β=0.29, p<0.001). In addition, patients with higher SI (β=0.88, p<0.001) and/or disease progression risk (β=0.42, p<0.001) tended to present higher levels of disease knowledge. CONCLUSIONS While successful KAP transformation has been achieved in practice for diet and physical activities, there is a need to improve foot care practice. Health education should also prioritise the prevention, detection and care of diabetic foot. Also, appropriate methods should be adopted to deliver health education to vulnerable patients, such as the elderly, those living in rural areas, those with minimal education, the unemployed and low-income patients.
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Affiliation(s)
- Wenjun Zhu
- School of Public Health, National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People's Republic of China
| | - Di Liang
- School of Public Health, National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People's Republic of China
| | - Jindong Ding Petersen
- Research Unit for General Practice, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
- International School of Public Health and One Health, Hainan Medical University, Haikou, China
| | - Weijun Zhang
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Jiayan Huang
- School of Public Health, National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People's Republic of China
| | - Yin Dong
- People's Hospital of Yuhuan, Taizhou, China
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Al-Qerem W, Jarab A, AlBawab AQ, Hammad A, Alazab B, Abu Husein D, Eberhardt J, Alasmari F. Examining Influenza Vaccination Patterns and Barriers: Insights into Knowledge, Attitudes, and Practices among Diabetic Adults (A Cross-Sectional Survey). Vaccines (Basel) 2023; 11:1689. [PMID: 38006021 PMCID: PMC10674532 DOI: 10.3390/vaccines11111689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Diabetes mellitus is a prevalent global chronic condition affecting individuals of all ages. People with diabetes face an elevated risk of lower respiratory tract infections such as pulmonary tuberculosis, influenza, and pneumonia. Additionally, the influenza virus increases the likelihood of deep venous thrombosis and pulmonary embolism. This study examined the knowledge, attitudes, and practices of diabetic patients regarding the influenza vaccine. This study involved 418 diabetic patients (53.3% female) at Jordanian outpatient respiratory clinics, with an average age of 49 (±14) years. The results showed that 70.6% had never received the influenza vaccine, and only 23.7% intended to do so in the current year. A positive attitude toward the influenza vaccine significantly reduced hesitancy to get vaccinated (OR = 0.505, 95% CI 0.424-0.601, p < 0.001). The duration of diabetes exhibited a positive association with vaccine hesitancy (OR = 1.053, 95% CI 1.006-1.102, p = 0.028). The primary reason for not getting vaccinated was a lack of awareness of its benefits (42.6%). Future health education programs should emphasize the importance of the influenza vaccine for diabetic patients and address their concerns.
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Affiliation(s)
- Walid Al-Qerem
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (A.Q.A.); (A.H.); (B.A.); (D.A.H.)
| | - Anan Jarab
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan;
- College of Pharmacy, Al Ain University, Abu Dhabi 112612, United Arab Emirates
| | - Abdel Qader AlBawab
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (A.Q.A.); (A.H.); (B.A.); (D.A.H.)
| | - Alaa Hammad
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (A.Q.A.); (A.H.); (B.A.); (D.A.H.)
| | - Badi’ah Alazab
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (A.Q.A.); (A.H.); (B.A.); (D.A.H.)
| | - Daoud Abu Husein
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (A.Q.A.); (A.H.); (B.A.); (D.A.H.)
| | - Judith Eberhardt
- School of Social Sciences, Humanities and Law, Department of Psychology, Teesside University, Borough 15 Road, Middlesbrough TS1 3BX, UK;
| | - Fawaz Alasmari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 12372, Saudi Arabia;
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Zemba D, Sagna Y, Traore S, Zoungrana L, Somé DP, Kissou SA, Guira O, Yaméogo TM. Diabetes knowledge and associated factors in adolescents and young adults with type 1 diabetes in Ouagadougou (Burkina Faso). BMC Endocr Disord 2023; 23:210. [PMID: 37777715 PMCID: PMC10544174 DOI: 10.1186/s12902-023-01469-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 09/25/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Type 1 diabetes (T1D) in youth is becoming a public health problem in Sub-Saharan Africa, including Burkina Faso. However, little is known about the level of knowledge of these patients on T1D. This study aimed to evaluate the knowledge of diabetes in adolescents and young adults about the disease, and identify the factors associated in Burkina Faso. METHODS A cross-sectional survey was conducted from April to June 2020 among youth with T1D, aged 10 to 30 years, and regularly followed in the internal medicine department of Yalgado Ouedraogo University Hospital of Ouagadougou, Burkina Faso. Data were collected using the French AJD (Aide aux Jeunes Diabétiques) validated diabetes knowledge and skills (DKS) questionnaire designed to test participants' accuracy in knowledge about six different themes of T1D, as generalities of diabetes, hypoglycemia and hyperglycemia, management of insulin treatment, and self-monitoring blood glucose (SMBG). DKS level was determined by calculating the scores, and univariate and multivariate logistic regression were used to explore factors influencing DKS scores. This level was classified as insufficient or low ≤ 25/50, regular 26-39/50, and adequate or good ≥ 40/50. RESULTS Sixty-three participants with a mean age of 19.05 years and a sex ratio (W/M) of 1.17 were included in our study. The mean HbA1c level was 9.79%, and 43 (68.23%) patients had an insufficient DKS level. The mean global DKS score of correct answers was 23.63/50. The percentage of correct answers was respectively 50% for the item "generalities of diabetes", 32.4% for the item "hypoglycemia and hyperglycemia", 67.72% for the item "diet", 37.34% for the item "management of insulin treatment" and 44.97% for the item "SMBG". In univariate analysis, a better patient DKS level was associated with university education and long duration of diabetes care follow-up (> 10 years, p < 0.05). Only increasing age remain associated with a better knowledge score (p < 0.05) in multivariate analysis. CONCLUSION This study is an important first step in identifying areas for intervention efforts about therapeutic education for youth with type I diabetes in Burkina Faso.
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Affiliation(s)
- Daniel Zemba
- Service de médecine interne, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso.
| | - Yempabou Sagna
- Institut Supérieur des Sciences de la Santé, Université Nazi BONI, Bobo Dioulasso, Burkina Faso
- Service de Médecine Interne, CHU Sourô Sanou, Bobo Dioulasso, Burkina Faso
| | - Solo Traore
- Service de médecine interne, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Lassane Zoungrana
- Service de médecine interne, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso
- Unité de Formation et de Recherche en Sciences de la Santé, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - D Patricia Somé
- Service de médecine interne, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - S Aimée Kissou
- Institut Supérieur des Sciences de la Santé, Université Nazi BONI, Bobo Dioulasso, Burkina Faso
- Service de Pédiatrie, CHU Sourô Sanou, Bobo Dioulasso, Burkina Faso
| | - Oumar Guira
- Service de médecine interne, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso
- Unité de Formation et de Recherche en Sciences de la Santé, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - Téné Marceline Yaméogo
- Institut Supérieur des Sciences de la Santé, Université Nazi BONI, Bobo Dioulasso, Burkina Faso
- Service de Médecine Interne, CHU Sourô Sanou, Bobo Dioulasso, Burkina Faso
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Almousa AY, Hakami OA, Qutob RA, Alghamdi AH, Alaryni AA, Alammari YM, Al Harbi KM, Alyousef MA, Amlih MF, Althnayan MA, Almutairy MB. Knowledge, Attitude, and Practice Toward Diabetes Mellitus and Their Association With Socioeconomic Status Among Patients With Type 2 Diabetes Mellitus in Saudi Arabia. Cureus 2023; 15:e39641. [PMID: 37388615 PMCID: PMC10306255 DOI: 10.7759/cureus.39641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVES The objective is to assess knowledge, attitude, and practice toward diabetes mellitus (T2DM) and its association with socioeconomic status among adult patients with T2DM. METHODS This cross-sectional study used the validated "Diabetes Knowledge Test (DKT)" questionnaire obtained from the Michigan Diabetes Research Center. A translated copy into Arabic has been validated and used in another study. The questionnaire was created on Google Forms and distributed through digital platforms to collect data from patients with T2DM in Saudi Arabia. RESULTS In this study, the majority were female (63.4%), and Saudi Arabians (96.5%), among them 23.7% lived in Riyadh, and 42.8% were from the central region. As for marital status, 60.5% were married, 28.4% were single, and 11.1% were divorced or widowed. 58.9% had college/higher degrees, and 45.8% were unemployed. Furthermore, the majority (47.1%) reported having a salary of less than 5,000 Saudi Riyals per month. 55.1% of participants lived in villas, while 46.6% had 6-10 people living in their household. Generalized linear model (GLM) findings showed that age, marital status, level of education, monthly income, and accommodation are significantly correlated with the level of knowledge. CONCLUSION Findings indicated a high level of knowledge, positive behavior, and good adherence to practice among patients with T2DM. GLM findings showed that age, marital status, level of education, monthly income, and accommodation are significantly correlated with the level of knowledge. Researchers suggest that effective health education interventions are needed to improve diabetes knowledge, behavior, and practices, particularly regarding lifestyle modifications and dietary management.
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Affiliation(s)
| | - Osamah A Hakami
- Department of Internal Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Rayan A Qutob
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Abdullah H Alghamdi
- Department of Internal Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Abdullah A Alaryni
- Department of Internal Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Yousef M Alammari
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Khalid M Al Harbi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Meshal A Alyousef
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Mohammad F Amlih
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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Feng Y, Zhao Y, Mao L, Gu M, Yuan H, Lu J, Zhang Q, Zhao Q, Li X. The Effectiveness of an eHealth Family-Based Intervention Program in Patients With Uncontrolled Type 2 Diabetes Mellitus (T2DM) in the Community Via WeChat: Randomized Controlled Trial. JMIR Mhealth Uhealth 2023; 11:e40420. [PMID: 36939825 PMCID: PMC10131610 DOI: 10.2196/40420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/09/2022] [Accepted: 03/01/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND Intervention based on family support and risk perception can enhance type 2 diabetes mellitus (T2DM) patients' self-care activities. In addition, eHealth education is considered to improve family members' support for patients with T2DM. However, there is little evidence from rigorously designed studies on the effectiveness of an intervention combining these approaches. OBJECTIVE This randomized controlled trial (RCT) aimed to assess the effectiveness of an eHealth family-based health education intervention for patients with T2DM to improve their glucose control, risk perception, and self-care behaviors. METHODS This single-center, 2-parallel-group RCT was conducted between 2019 and 2020. Overall, 228 patients were recruited from Jiading District, Shanghai, and randomly divided into intervention and control groups. The intervention group received an eHealth family intervention based on community management via WeChat, whereas the control group received usual care. The primary outcome was the glycated hemoglobin (HbA1c) level of the patients with T2DM, and the secondary outcomes were self-management behavior (general and specific diet, exercise, blood sugar testing, foot care, and smoking), risk perception (risk knowledge, personal control, worry, optimism bias, and personal risk), and family support (supportive and nonsupportive behaviors). A 2-tailed paired-sample t test was used to compare the participants at baseline and follow-up within the control and intervention groups. An analysis of covariance was used to measure the intervention effect. RESULTS In total, 225 patients with T2DM were followed up for 1 year. After intervention, they had significantly lower HbA1c values (β=-.69, 95% CI -0.99 to -0.39; P<.001). They also had improved general diet (β=.60, 95% CI 0.20 to 1.00; P=.003), special diet (β=.71, 95% CI 0.34 to 1.09; P<.001), blood sugar testing (β=.50, 95% CI 0.02 to 0.98; P=.04), foot care (β=1.82, 95% CI 1.23 to 2.42; P<.001), risk knowledge (β=.89, 95% CI 0.55 to 1.24; P<.001), personal control (β=.22, 95% CI 0.12 to 0.32; P<.001), worry (β=.24, 95% CI 0.10 to 0.39; P=.001), optimism bias (β=.26, 95% CI 0.09 to 0.43; P=.003), and supportive behaviors (β=5.52, 95% CI 4.03 to 7.01; P<.001). CONCLUSIONS The eHealth family-based intervention improved glucose control and self-care activities among patients with T2DM by aiding the implementation of interventions to improve T2DM risk perceptions among family members. The intervention is generalizable for patients with T2DM using health management systems in community health centers. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900020736; https://www.chictr.org.cn/showprojen.aspx?proj=31214.
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Affiliation(s)
- Yuheng Feng
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
- China Research Center on Disability Issues, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai, China
| | - Yuxi Zhao
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
- China Research Center on Disability Issues, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai, China
| | - Linqi Mao
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
- China Research Center on Disability Issues, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai, China
| | - Minmin Gu
- Juyuan New District Community Health Service Center, Jiading District, Shanghai, China
| | - Hong Yuan
- Shanghai Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Jun Lu
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
- China Research Center on Disability Issues, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai, China
| | - Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA, United States
| | - Qian Zhao
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
- China Research Center on Disability Issues, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai, China
| | - Xiaohong Li
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
- China Research Center on Disability Issues, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai, China
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Iregbu S, Spiers J, Duggleby W, Salami B, Schick-Makaroff K. Nigerian Health Care Providers and Diabetes Self-Management Support: Their Perspectives and Practices. QUALITATIVE HEALTH RESEARCH 2023; 33:92-105. [PMID: 36519805 PMCID: PMC9827480 DOI: 10.1177/10497323221143889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Nigeria struggles to reframe its traditional acute-care disease approach to health care to accommodate rising needs for chronic disease care. This interpretive descriptive study explored Nigerian healthcare providers' (HCPs) perspectives, experiences, and practices related to self-management support (SMS). Observational and experiential data were gathered from 19 HCPs at two urban hospitals in Southeastern Nigeria (seven physicians, four nurses, five dietitians/nutritionists, and three health educators). There were four themes: (a) compliance-oriented medical model, (b) SMS as advice, informal counseling, and education, (c) navigating the sociocultural terrain, and (d) workarounds. Nigerian HCPs perspectives and SMS practices were characterized by attempts to foster compliance with healthcare instructions within a traditional biomedical model. Participants enhanced patient support using specific strategies to bypass structural system obstacles. These findings demonstrate the need to reevaluate the current understanding of SMS in Nigeria and its practice.
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Affiliation(s)
- Sandra Iregbu
- Faculty of Nursing,
University
of Alberta, Ave Edmonton, AB,
Canada
| | - Jude Spiers
- Faculty of Nursing,
University
of Alberta, Ave Edmonton, AB,
Canada
| | - Wendy Duggleby
- Faculty of Nursing,
University
of Alberta, Ave Edmonton, AB,
Canada
| | - Bukola Salami
- Faculty of Nursing,
University
of Alberta, Ave Edmonton, AB,
Canada
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Peng Z, Ma Y, Wang J, Xu X, Wang C, Chen Y. Awareness of Clinical Research Coordinators Toward Ethics and Protection of Clinical Trial Patients. Ther Innov Regul Sci 2022; 57:561-569. [PMID: 36572831 DOI: 10.1007/s43441-022-00488-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE Clinical research coordinators (CRCs) play an important role in the protection of clinical trial participants and maintenance of ethical standards. However, limited data are available on the ethical cognition of CRCs. Understanding the knowledge, attitude, and practices (KAP) of CRCs toward ethics is essential to protect study participants and improve their compliance. METHODS We conducted a descriptive, cross-sectional, quantitative study at 20 hospitals in Anhui province of China. A self-administered questionnaire was completed by 435 CRCs conducting clinical trials. RESULTS The good knowledge, positive attitude, and good practice rates were 55.2%, 59.3%, and 79.5% respectively. Most CRCs (99.1%) were aware of the participants' rights. Only 127 (29.2%) and 140 (32.2%) CRCs were aware of measures to protect participants' rights and ethical guidelines regarding trials, respectively. In total, 59.6% of CRCs stated that ethical review might delay the start of a clinical trial. Marital status (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.27-0.83), CRC work experience (OR 0.11, 95% CI 0.02-0.75), and educational background (OR 0.31, 95% CI 0.13-0.76) affected the knowledge of CRCs regarding ethics. CONCLUSIONS Some deficiencies were observed in the ethical knowledge and behavior of CRCs. Interventions to improve the ethical training of CRCs regarding study participant protection, international guidelines, and the role of ethical committees are essential when conducting clinical trials. Validated instruments should be constructed to assess the effectiveness of ethical training and measure the KAP of CRCs toward ethics.
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Factors Associated with Quality of Life in Patients with Type 2 Diabetes of South Benin: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042360. [PMID: 35206551 PMCID: PMC8871979 DOI: 10.3390/ijerph19042360] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 01/27/2023]
Abstract
Background: Type 2 diabetes (T2D) adversely affects health-related quality of life (QoL). However, little is known about the QoL of diabetic patients in Benin, where the disease is a growing concern. Thus, this study aims to assess the QoL and its associated factors among T2D patients in Cotonou, southern Benin. Methods: A total of 300 T2D patients (age > 18 years) were enrolled, and the diabetes-specific quality of life (DQoL) and Natividad self-care behaviors’ (SCB) instruments were used for data collection. DQoL scores were calculated, and factors associated with DQoL explored using logistic regression. Results: The mean of patients’ DQoL was 38.1 ± 4.1, with 43% having low QoL. In terms of DQoL, 56.3% reported a high diabetes impact, followed by low life satisfaction (53%) and high worry about diabetes (32.7%). In the logistic regression analysis, education, marital status, occupation, family history of diabetes, complications, and social support were associated with DQoL. SCB factors, including healthy eating, problem-solving, coping strategies, and risk reduction, were significant predictors of DQoL. Conclusions: Patients’ empowerment, starting with self-management education, is essential to improve the QoL of T2D patients in Cotonou. However, the programs need to target low education, low socioeconomic status, low social support, and overweight patients.
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Alaofè H, Yeo S, Okechukwu A, Magrath P, Amoussa Hounkpatin W, Ehiri J, Rosales C. Cultural Considerations for the Adaptation of a Diabetes Self-Management Education Program in Cotonou, Benin: Lessons Learned from a Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168376. [PMID: 34444125 PMCID: PMC8393923 DOI: 10.3390/ijerph18168376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 12/02/2022]
Abstract
Background: Type 2 diabetes (T2D) poses a disproportionate burden on Benin, West Africa. However, no diabetes intervention has yet been developed for Benin’s contexts. This study aimed to explore specific cultural beliefs, attitudes, behaviors, and environmental factors to help adapt a diabetes self-management program to patients with T2D from Cotonou, in southern Benin. Methods: Qualitative data were collected through focus group discussions (FDGs) involving 32 patients with T2D, 16 academic partners, and 12 community partners. The FDGs were audio-recorded, transcribed verbatim from French to English, and then analyzed thematically with MAXQDA 2020. Results: Healthy food was challenging to obtain due to costs, seasonality, and distance from markets. Other issues discussed were fruits and vegetables as commodities for the poor, perceptions and stigmas surrounding the disease, and the financial burden of medical equipment and treatment. Information about local food selections and recipes as well as social support, particularly for physical activity, were identified, among other needs. When adapting the curriculum, gender dynamics and spirituality were suggested. Conclusions: The study demonstrates the need for culturally sensitive interventions and a motivation-based approach to health (spiritual and emotional support). It also lays the groundwork for addressing T2D contextually in Benin and similar sub-Saharan African countries.
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Affiliation(s)
- Halimatou Alaofè
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA; (S.Y.); (A.O.); (P.M.); (J.E.)
- Correspondence: ; Tel.: +1-(520)-626-5614
| | - Sarah Yeo
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA; (S.Y.); (A.O.); (P.M.); (J.E.)
| | - Abidemi Okechukwu
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA; (S.Y.); (A.O.); (P.M.); (J.E.)
| | - Priscilla Magrath
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA; (S.Y.); (A.O.); (P.M.); (J.E.)
| | - Waliou Amoussa Hounkpatin
- School of Nutrition and Food Science and Technology, Faculty of Agricultural Sciences, University of Abomey-Calavi (FSA-UAC), Campus d’Abomey-Calavi, Calavi 01 BP 526, Benin;
| | - John Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA; (S.Y.); (A.O.); (P.M.); (J.E.)
| | - Cecilia Rosales
- Division of Public Health Practice & Translational Research, University of Arizona, Phoenix Plaza Building, 550 E. Van Buren Street, Phoenix, AZ 85006, USA;
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Patrick NB, Yadesa TM, Muhindo R, Lutoti S. Poor Glycemic Control and the Contributing Factors Among Type 2 Diabetes Mellitus Patients Attending Outpatient Diabetes Clinic at Mbarara Regional Referral Hospital, Uganda. Diabetes Metab Syndr Obes 2021; 14:3123-3130. [PMID: 34262316 PMCID: PMC8275135 DOI: 10.2147/dmso.s321310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/24/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Glycemic control is associated with long-term complications in type 2 diabetes management. However, updated reports on glycemic control that are crucial to reducing diabetes mellitus complications remain scarce. OBJECTIVE The objective of this study is to evaluate glycemic control and contributing factors among type 2 diabetes mellhitus patients attending the outpatient diabetic clinic at Mbarara Regional Referral Hospital. METHODS A cross-sectional study was conducted at Mbarara Regional Referral Hospital outpatient diabetes clinic between July and October 2020. Participants were subjected to a questionnaire-based interview and glycosylated hemoglobin (HbA1C) was determined as a marker of glycemic control among participants. The collected data was entered into and analyzed by Stata version 13. The odds ratio was used to determine the strength of association between variables. The cut-off value for all statistical significance tests was set at p<0.05 with CI of 95%. RESULTS A total of 223 participants were interviewed, and the majority (188, 84.3%) had poor glycemic control (HbA1C ≥7%). Importantly, 81.7% (49/60) and 90.0% (99/110) of those who did not adhere to diet and physical exercise recommendations respectively, had poor glycemic control. Multivariate logistic regression revealed that poor glycemic control was more prevalent among participants aged 25-60 years (AOR=4.48, 95%CI: 1.56-14.50, p-value=0.009) and those aged above 60 years (AOR=4.28, 95%CI: 1.18-15.58, p-value= 0.03) compared to the youth, 18-24 years of age. CONCLUSION The prevalence of poor glycemic control among type 2 diabetes patients in this study is high and patient's age was identified to be an independent risk factor. We recommend any intervention by the hospital that promotes diabetes education and optimizes lifestyle and medication adherence; ultimately to achieve good glycemic control especially for adult patients.
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Affiliation(s)
- Nsheka Bonny Patrick
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Tadele Mekuriya Yadesa
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
- World Bank, ACE II, Pharmacy Biotechnology and Traditional Medicine Center (PHARMBIOTRAC), Mbarara University of Science and Technology, Mbarara, Uganda
- Correspondence: Tadele Mekuriya Yadesa Department of Pharmacy, Mbarara University of Science and Technology, PO Box 1410, Mbarara, Uganda Email
| | - Rose Muhindo
- Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Stephen Lutoti
- Department of Pharmacy, Makerere University, Kampala, Uganda
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