A comparison of two methods of foot health education: The Fremantle Diabetes Study Phase II

• We compared written and interactive foot health education in type 2 diabetes.
• Written information was more effective at improving overall foot health.
• Interactive education promoted greater confidence in implementing preventive measures.
• Fear of amputation was common and unchanged by either intervention.
• The most effective foot care education should include both educational strategies.

AimsTo compare the effectiveness of two different methods of education on foot health, behaviours and attitudes in patients with type 2 diabetes.MethodsCommunity-based patients were consecutively allocated to written education (Group A) or an interactive educator-led session (Group B). A quantitative Foot Score (maximum 90 points score based on severity of treatable pathology), the Nottingham Assessment of Functional Foot Care (NAFFC) survey score (maximum 30 points reflecting frequency of foot care behaviours) and a 6-question survey of attitudes to foot complications were administered at baseline and 3 months.Results154 patients (mean ± SD age 68 ± 10 years, 59.7% males, median [interquartile range] diabetes duration 11.5 [5.6–18.9] years) were recruited. There was a greater change (Δ) in Foot Score from baseline to 3 months in Group A (8.3 ± 3.6, Δ − 1.8 (95% CI: −2.4 to −1.2) vs Group B (6.8 ± 2.6, Δ − 0.1 (−0.7 to 0.4); P < 0.001), but no change in NAFFC survey score in either group (P = 0.13). In the attitudes survey, Group B felt they better understood how to prevent foot complications than Group A after education (P = 0.031).ConclusionsWritten information was more effective at improving foot health while interactive education improved confidence in undertaking preventive measures, suggesting that the most effective foot care education should include both components.