ONE-TO-ONE TEACHING WITH PICTURES - FLASHCARD HEALTH-EDUCATION FOR BRITISH-ASIANS WITH DIABETES

Background. Type 2 diabetes is up to four times more common in British Asians, but they know little about its management and complications. Aim. To design and evaluate a structured pictorial teaching programme for Pakistani Moslem patients in Manchester with type 2 diabetes. Meth od. A randomized controlled trial of pictorial flashcard one-to-one ed ucation in 201 patients attending a hospital outpatient clinic or diab etic clinics in ten general practices in Manchester. Patients' knowled ge, self-caring skills and attitudes to diabetes were measured on four topics before the structured teaching, and compared with results six months later. Results. All parameters of knowledge were increased in t he study group; for example, percentage scores for correctly identifyi ng different food values increased from 57% to 71% (Analysis of Varian ce (ANOVA) adjusted difference +11.8%) and knowledge of one diabetic c omplication from 18% to 78%. Self-caring behaviour improved, with 92% of patients doing regular glucose tests at six months compared with 63 % at the start. Attitudinal Views were more resistant to change, with patients still finding it hard to choose suitable foods at social occa sions. Haemoglobin A1c control improved by 0.34% over six months (ANOV A adjusted difference, 95% CI-0.8% to +0.1%). Conclusion. It is conclu ded that this health education programme can empower Asian diabetics t o take control of their diets, learn to monitor and interpret glucose result, and understand the implications of poor glycaemic control for diabetic complications.