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

dc.contributor.authorMash, Boben_ZA
dc.contributor.authorLevitt, Naomien_ZA
dc.contributor.authorSteyn, Kriselaen_ZA
dc.contributor.authorZwarenstein, Merricken_ZA
dc.contributor.authorRollnick, Stephenen_ZA
dc.date.accessioned2015-11-18T03:55:08Z
dc.date.available2015-11-18T03:55:08Z
dc.date.issued2012en_ZA
dc.description.abstractBACKGROUND: 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 PACTR201205000380384en_ZA
dc.identifier.apacitationMash, B., Levitt, N., Steyn, K., Zwarenstein, M., & Rollnick, S. (2012). Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial. <i>BMC Family Practice</i>, http://hdl.handle.net/11427/15062en_ZA
dc.identifier.chicagocitationMash, Bob, Naomi Levitt, Krisela Steyn, Merrick Zwarenstein, and Stephen Rollnick "Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial." <i>BMC Family Practice</i> (2012) http://hdl.handle.net/11427/15062en_ZA
dc.identifier.citationMash, B., Levitt, N., Steyn, K., Zwarenstein, M., & Rollnick, S. (2012). Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial. BMC family practice, 13(1), 126.en_ZA
dc.identifier.ris TY - Journal Article AU - Mash, Bob AU - Levitt, Naomi AU - Steyn, Krisela AU - Zwarenstein, Merrick AU - Rollnick, Stephen AB - 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 DA - 2012 DB - OpenUCT DO - 10.1186/1471-2296-13-126 DP - University of Cape Town J1 - BMC Family Practice LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial TI - Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial UR - http://hdl.handle.net/11427/15062 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15062
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2296-13-126
dc.identifier.vancouvercitationMash B, Levitt N, Steyn K, Zwarenstein M, Rollnick S. Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial. BMC Family Practice. 2012; http://hdl.handle.net/11427/15062.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDivision of Endocrinology and Diabetologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2012 Mash et al.; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Family Practiceen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcfampract/en_ZA
dc.subject.otherDiabetesen_ZA
dc.subject.otherGroup educationen_ZA
dc.subject.otherHealth educationen_ZA
dc.subject.otherMotivational interviewingen_ZA
dc.subject.otherMid-level health workersen_ZA
dc.subject.otherSouth Africaen_ZA
dc.subject.otherPrimary careen_ZA
dc.titleEffectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trialen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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