TAILIEUCHUNG - Effectiveness of PRECEDE model for health education on changes and level of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes mellitus

The retirement crisis is directly attributable to the failure of the “three-legged stool” of retirement security. Traditionally, defined benefit pension plans (“pensions”), personal savings, and Social Security were seen as the three pillars creating a solid foundation for our retirement system. Each should play an important role in supporting people in old age. However, the stool, never sturdy, has become increasingly wobbly as pensions have disappeared and the middle class is finding it harder and harder to save. . | Salinero-Fort et al. BMC Public Health 2011 11 267 http 1471-2458 11 267 BMC Public Health RESEARCH ARTICLE Open Access Effectiveness of PRECEDE model for health education on changes and level of control of HbA1c blood pressure lipids and body mass index in patients with type 2 diabetes mellitus 1 t 3t 2 3 Miguel A Salinero-Fort Enrique Carrillo-de Santa Pau Francisco J Arrieta-Blanco Juan C Abanades-Herranz Carmen Martín-Madrazo3 Berta Rodés-Soldevila 1 and Carmen de Burgos-Lunar4 Abstract Background Individual health education is considered to be essential in the overall care of patients with type 2 diabetes DM2 although there is some uncertainty regarding its metabolic control benefits. There have been very few randomized studies on the effects of individual education on normal care in DM2 patients with a control group and none of these have assessed the long-term results. Therefore this study aims to use this design to assess the effectiveness of the PRECEDE Predisposing Reinforcing Enabling Causes in Educational Diagnosis and Evaluation education model in the metabolic control and the reduction of cardiovascular risk factors in patients with type 2 diabetes. Methods An open community effectiveness study was carried out in 8 urban community health centers in the North-East Madrid Urban Area Spain . Six hundred patients with DM2 were randomized in two groups PRECEDE or conventional model for health promotion education. The main outcome measures were glycated hemoglobin A1c body mass index BMI blood pressure lipids and control criteria during the 2-year follow-up period. Results Glycated hemoglobin A1c and systolic blood pressure SBP levels decreased significantly in the PRECEDE group multivariate analysis of covariance with baseline glycated hemoglobin A1c SBP and variables showing statistically significant differences between groups at baseline visits . The decrease levels in diastolic blood pressure DBP triglycerides and LDL cholesterol .

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