Abstract
•Diabetic foot ulcers are the leading cause of lower limp amputations worldwide•Disadvantaged pacific islanders have the highest rates of diabetes and amputations•A clinical intervention program is implemented as a solution•Foot care intervention program is efficacious in battling diabetes and its complications•Low income countries can improve diabetes care through appropriate programs
Aim: To evaluate the clinical success of a first and longitudinal peer-to-peer support group foot care intervention program in a prospective cohort of persons with diabetes in a disadvantaged population.
Method: A prospective cohort-based study design was implemented using standard protocols. A knowledge, attitude, and practice (KAP) instrument toward foot care was administered to persons with type 2 diabetes mellitus before and after the intervention program was implemented. The KAP instrument achieved very high overall and component Cronbach alpha reliability.
Results: The average age of the patients at the time of the pre-intervention was 57.9 years (SD ± 9.8). Sixty-nine percent are females, 44.5% are natives (I-Taukei) and 55.5% are migrant Indians (Indo-Fijians), and 76.4% completed high school. Univariate analyses reveal a highly statistically significant and clinically meaningful increase in the component KAP scores following the foot care intervention program. Results from multiple regression analyses adjusting for patient demographics and confounders show significant improvements in patients’ KAP toward foot care.
Conclusion: The success and efficacy of this foot care intervention program suggests that other countries with limited resources battling diabetes driven foot care hospitalizations and amputations can implement a similar cost-efficient public health education and awareness model as an initial step. This approach can alleviate the stress on healthcare systems during a pandemic.