Effect of Behavior Change Communication on Self-Care Practices Among Adult Type-2 Diabetic Patients in a Semi-urban Community of South India: A Quasi-Experimental Study

Background: Diabetes mellitus is often termed the modern epidemic, and India ranks second after China in the global disease burden. Practice and adherence to essential self-care behaviors, positively correlated with good glycemic control and reduced complications in people with diabetes, have been inadequately understood, especially in a semi-urban setting. Methods: This community-based interventional study was done among 269 known adult type 2 diabetic patients from a semi-urban community in South India for three months. By simple random sampling, known diabetics identified in the health survey by the tertiary care teaching institute were considered for the study. Self-care practices in diabetes were recorded in the pre-test using a validated semi-structured questionnaire. Two health education sessions, each for 30 minutes, were conducted with 15-20 subjects in a group. Health education materials on self-care in diabetes, such as charts, handouts, video clippings, and PowerPoint presentations in the local language, were used. The self-care practices were re-recorded in the post-test after two months. Inferential statistics were carried out with a t-test, analysis of variance (ANOVA), and Pearson correlation coefficient, and a p-value less than 0.05 was considered statistically significant. Results: A total of 253 diabetic subjects were included in the final analysis, with an attrition rate of 6%. The mean age of participants was 56.5 +/- 11.9 years. The mean score of self-care practices among diabetic subjects at the baseline was 14.6 +/- 13.2. Illiteracy and smoking habit were significantly associated with lower self-care scores in the pre-test. In the post-test, after health education, there was a significant improvement in the mean self-care practices score and a reduction in the mean fasting blood sugar level. Also, a significant mild negative correlation between the self-care scores and blood sugar levels was seen (Pearson correlation coefficient =-0.21, p < 0.001). Conclusion: Self-care practices, which were not satisfactory in most diabetic participants, were found to be significantly impacted by the small group education. This stresses the need for effective health education sessions as envisaged under the national program.