Outcomes of a type 2 diabetes education program adapted to the cultural contexts of Saudi women

Objective: To explore the outcomes of a pilot intervention of a type 2 diabetes (T2D) education program, based on international standards, and adapted to the cultural and religious contexts of Saudi women. Methods: This study is an experiment of a pilot intervention carried out between August 2011 and January 2012 at the primary health clinics in Dammam. Women at risk of or diagnosed with T2D (N=35 including dropouts) were assigned to one of 2 groups; an intervention group participated in a pilot intervention of T2D education program, based on international standards and tailored to their cultural and religious contexts; and a usual care group received the usual care for diabetes in Saudi Arabia. Outcomes included blood glucose, body composition, 6-minute walk distance, life satisfaction, quality of life, and diabetes knowledge. The intervention group participated in a focus group of their program experience. Data analysis was based on mixed methods. Results: Based on 95% confidence interval comparisons, improvements were noted in blood sugar, 6-minute walk distance, quality of life, and diabetes knowledge in participants of the intervention group. They also reported improvements in lifestylerelated health behaviors after the education program. Conclusion: Saudi women may benefit from a T2D education program based on international standards and adapted to their cultural and religious contexts. Saudi Med J 2015; Vol. 36 (7): 869-873 doi: 10.15537/smj.2015.7.11681 S women have a higher prevalence of obesity than men, which increases their risk of type 2 diabetes (T2D).1 The reporting of diabetes is higher in women compared to men in all provinces of Saudi Arabia.1 Diabetes education programs in Saudi Arabia do not target people at risk of diabetes with emphasis on diabetes prevention and feasible changes to lifestyle behaviors.2 Scientific evidence suggests that diabetes education programs based on international standards of lifestyle behaviors, are more effective when tailored to the cultures and religions of targeted groups.3-6 The aim of this study was to explore the outcomes of a pilot intervention of a T2D education program based on international standards and adapted to the cultural and religious contexts of Saudi women. Specifically, whether such a program can impact health outcomes (for example, physical health measures, diabetes knowledge, life satisfaction, and health-related quality of life, diabetes knowledge) in comparison with the usual care of T2D in Saudi Arabia. Methods. Ethical approval was obtained from the ethical review boards of the participating university and medical research administration board (The University of British Columbia, Vancouver, Canada, and the Saudi Administration for Medical Research, Riyadh, Saudi Arabia). Ethical approval standards are consistent with the requirements of the Helsinki Declaration. The study was an experiment of a pilot intervention of a 6-week T2D education program carried out between August 2011 and January 2012. Potential participants were recruited from the 3 largest primary health clinics in Dammam. Inclusion criteria were women 17 to 70 years of age, at risk of or diagnosed with T2D. Women who were pregnant were excluded. The number of study participants was 35 with initial dropouts of 16 prior to the start of the program. The 6-week education program was launched in a primary health clinic close to where most participants lived. Assigning participants to a group was based on their location and willingness and ability to attend the sessions of the 6-week education program. Participants were assigned to one of 2 groups. The intervention group participated in a T2D education program based on international standards and adapted to the cultural and religious contexts of women in Saudi Arabia. The usual care group received the usual care for T2D only. For all participants, objective measures included random blood sugar based on a finger-prick procedure (mg/dl), waist-to-hip ratio (WHR), weight (kg), height (cm), and body mass index (BMI) (weight Brief Communication Disclosure. Authors have no conflict of interests, and the work was not supported or funded by any drug company.