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BMC Fam Pract. 2012 Dec 24;13:126. doi: 10.1186/1471-2296-13-126.

Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial.

Author information

1
Family Medicine and Primary Care, Stellenbosch University, Box 19063, Tygerberg 7505, South Africa. rm@sun.ac.za

Abstract

BACKGROUND:

Diabetes is an important contributor to the burden of disease in South Africa and prevalence rates as high as 33% have been recorded in Cape Town. Previous studies show that quality of care and health outcomes are poor. The development of an effective education programme should impact on self-care, lifestyle change and adherence to medication; and lead to better control of diabetes, fewer complications and better quality of life.

METHODS:

TRIAL DESIGN:

Pragmatic cluster randomized controlled trialParticipants: Type 2 diabetic patients attending 45 public sector community health centres in Cape TownInterventions: The intervention group will receive 4 sessions of group diabetes education delivered by a health promotion officer in a guiding style. The control group will receive usual care which consists of ad hoc advice during consultations and occasional educational talks in the waiting room.

OBJECTIVE:

To evaluate the effectiveness of the group diabetes education programmeOutcomes:

PRIMARY OUTCOMES:

diabetes self-care activities, 5% weight loss, 1% reduction in HbA1c.

SECONDARY OUTCOMES:

self-efficacy, locus of control, mean blood pressure, mean weight loss, mean waist circumference, mean HbA1c, mean total cholesterol, quality of lifeRandomisation: Computer generated random numbersBlinding: Patients, health promoters and research assistants could not be blinded to the health centre's allocationNumbers randomized: Seventeen health centres (34 in total) will be randomly assigned to either control or intervention groups. A sample size of 1360 patients in 34 clusters of 40 patients will give a power of 80% to detect the primary outcomes with 5% precision. Altogether 720 patients were recruited in the intervention arm and 850 in the control arm giving a total of 1570.

DISCUSSION:

The study will inform policy makers and managers of the district health system, particularly in low to middle income countries, if this programme can be implemented more widely.

TRIAL REGISTER:

Pan African Clinical Trial Registry PACTR201205000380384.

PMID:
23265076
PMCID:
PMC3560091
DOI:
10.1186/1471-2296-13-126
[Indexed for MEDLINE]
Free PMC Article

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