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Short-Term Effects of an Educational Program on Health-Seeking Behavior for Infections in Patients With Type 2 Diabetes

A randomized controlled intervention trial in primary care

From the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands

Address correspondence and reprint requests to Prof. G.E.H.M. Rutten, Str. HP 6.131, UMC Utrecht, Julius Center for Health Sciences and Primary Care, P.O. Box 85500, 3508 GA Utrecht, Netherlands. E-mail: g.e.h.m.rutten{at}umcutrecht.nl

OBJECTIVE—The aim of this study was to assess the short-term effects of an educational program on (determinants of) self-reported health-seeking behavior for infections of the urinary tract (UTIs) and lower respiratory tract (LRTIs) in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS—In a randomized controlled trial, 1,124 patients with type 2 diabetes aged between 44 and 85 years participated. The intervention consisted of a multifaceted educational program with an interactive meeting, a leaflet, a Web site, and a consultation with the diabetes care provider. The program focused on the needs of patients, apparent from a prior focus group and questionnaire study. The primary outcome measure was an indicator of health-seeking behavior for UTIs and LRTIs, defined as the proportion of participants with a positive score on at least seven of nine determinants, six from the Health Belief Model and the additional three domains of knowledge, need for information, and intention. The primary outcome was measured with questionnaires at baseline and after 5 months.

RESULTS—Complete outcome data were available for 468 intervention group patients and 472 control group patients. In all, 68% of the intervention group patients attended the meeting. At baseline, 28% of the participants from the intervention group had a positive score on seven of the nine determinants, compared with 27% from the control group. After the educational program, these percentages were 53 and 32%, respectively (P < 0.001).

CONCLUSIONS—Our educational program positively influenced determinants of health-seeking behavior for common infections in patients with type 2 diabetes.

Abbreviations: GP, general practitioner • ITT, intention to treat • LRTI, lower respiratory tract infection • UTI, urinary tract infection

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