Effect of a community-based intervention on self-care among diabetes patients in rural Tamil Nadu: A mixed-method study.

Abstract

Peer support models for the management of diabetes self-care have been hailed as a promising solution to strengthen a formal health system to support diabetes patients. Diabetes self-care in patients can truncate the risk factors and reduce the complications. To identify self-care level (adherence to the diet, exercise, treatment) and depression among known diabetes patients and to find the effect of the support group intervention on diabetes self-care. A Sequential type Embedded Mixed-Method study (qual→QUAN(qual)→qual) was conducted in three phases in 168 known diabetes adults aged ≥ 30 years in a rural setting. After obtaining IEC clearance, the intervention was carried out over eight months, forming peer support groups in four villages. Each group comprises between six to 12 participants. Assessment of self-care, treatment adherence and depression with standardized scales. A manual content analysis was performed on the qualitative data. The Wilcoxon rank test was used to compare the quantitative data before and after intervention and analyzed using SPSS (Version_24) software package. In this study, we found improved self-care practices and treatment adherence among study participants (p < 0.001). About 88.7% of participants said that the support group was useful and provided moral support for diabetes. We found an improvement in treatment adherence, self-care among diabetes patients' and marginal improvement in depression status through support group intervention. Also the peer support group was well accepted, and it provided the low-cost, feasible intervention respect to the chronic conditions like diabetes, by addressing their behavioral changes and support from community. By sustaining the support group, might able to achieve the efficient health care in high quality even at resource-poor settings. A Community-Based intervention for the diabetes self-care using peer support group among the diabetes patients will improve the self-care practices in the area with limited access to healthcare and financial resources, it provides a low-cost, flexible, culturally sensitive approach to support self-care management and reduce the further complications among It also imporve the problem-solving capacity and social support from families and peers patients.