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Socioeconomic factors and effect of evidence-based patient information about primary prevention of type 2 diabetes mellitus - are there interactions?

BACKGROUND: Having shown in a recent randomized controlled trial that evidence-based patient information (EBPI) significantly increased knowledge on primary prevention of diabetes compared to standard patient information, we now investigated interaction between socioeconomic status (SES) and the eff...

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Autores principales: Genz, Jutta, Haastert, Burkhard, Müller, Hardy, Verheyen, Frank, Cole, Dennis, Rathmann, Wolfgang, Nowotny, Bettina, Roden, Michael, Giani, Guido, Ohmann, Christian, Icks, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4148532/
https://www.ncbi.nlm.nih.gov/pubmed/25134530
http://dx.doi.org/10.1186/1756-0500-7-541
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author Genz, Jutta
Haastert, Burkhard
Müller, Hardy
Verheyen, Frank
Cole, Dennis
Rathmann, Wolfgang
Nowotny, Bettina
Roden, Michael
Giani, Guido
Ohmann, Christian
Icks, Andrea
author_facet Genz, Jutta
Haastert, Burkhard
Müller, Hardy
Verheyen, Frank
Cole, Dennis
Rathmann, Wolfgang
Nowotny, Bettina
Roden, Michael
Giani, Guido
Ohmann, Christian
Icks, Andrea
author_sort Genz, Jutta
collection PubMed
description BACKGROUND: Having shown in a recent randomized controlled trial that evidence-based patient information (EBPI) significantly increased knowledge on primary prevention of diabetes compared to standard patient information, we now investigated interaction between socioeconomic status (SES) and the effect of an EBPI. FINDINGS: 1,120 visitors (aged 40–70 years, without known diabetes) to the “Techniker Krankenkasse” and the “German Diabetes Center” websites were randomized. The intervention group received a newly developed on-line EBPI, the control group standard on-line information. The primary outcome measure was knowledge, classified as “good/average/poor”. We analyzed associations of knowledge with socioeconomic variables (education, vocational training, employment, subjective social status) combined with intervention effect including interactions, adjusted for possible confounding by knowledge before intervention, self–reported blood glucose measurements, blood pressure, blood lipid levels, age and gender. Logistic regression models were fitted to the subpopulation (n = 647) with complete values in these variables. Education (high vs. low) was significantly associated with knowledge (good vs. average/poor); however, there was no significant interaction between education and intervention. After adjustment, the other socioeconomic variables were not significantly associated with knowledge. CONCLUSIONS: Socioeconomic variables did not significantly change the effect of the intervention. There was a tendency towards a lower effect where lower educated individuals were concerned. Possibly the power was too low to detect interaction effects. Larger studies using SES-specific designs are needed to clarify the effect of SES. We suggest considering the socioeconomic status when evaluating a decision aid, e.g. an EBPI, to ensure its effectiveness not only in higher socioeconomic groups. TRIAL REGISTRATION: Current Controlled Trials ISRCTN22060616 (Date assigned: 12 September 2008).
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spelling pubmed-41485322014-08-29 Socioeconomic factors and effect of evidence-based patient information about primary prevention of type 2 diabetes mellitus - are there interactions? Genz, Jutta Haastert, Burkhard Müller, Hardy Verheyen, Frank Cole, Dennis Rathmann, Wolfgang Nowotny, Bettina Roden, Michael Giani, Guido Ohmann, Christian Icks, Andrea BMC Res Notes Short Report BACKGROUND: Having shown in a recent randomized controlled trial that evidence-based patient information (EBPI) significantly increased knowledge on primary prevention of diabetes compared to standard patient information, we now investigated interaction between socioeconomic status (SES) and the effect of an EBPI. FINDINGS: 1,120 visitors (aged 40–70 years, without known diabetes) to the “Techniker Krankenkasse” and the “German Diabetes Center” websites were randomized. The intervention group received a newly developed on-line EBPI, the control group standard on-line information. The primary outcome measure was knowledge, classified as “good/average/poor”. We analyzed associations of knowledge with socioeconomic variables (education, vocational training, employment, subjective social status) combined with intervention effect including interactions, adjusted for possible confounding by knowledge before intervention, self–reported blood glucose measurements, blood pressure, blood lipid levels, age and gender. Logistic regression models were fitted to the subpopulation (n = 647) with complete values in these variables. Education (high vs. low) was significantly associated with knowledge (good vs. average/poor); however, there was no significant interaction between education and intervention. After adjustment, the other socioeconomic variables were not significantly associated with knowledge. CONCLUSIONS: Socioeconomic variables did not significantly change the effect of the intervention. There was a tendency towards a lower effect where lower educated individuals were concerned. Possibly the power was too low to detect interaction effects. Larger studies using SES-specific designs are needed to clarify the effect of SES. We suggest considering the socioeconomic status when evaluating a decision aid, e.g. an EBPI, to ensure its effectiveness not only in higher socioeconomic groups. TRIAL REGISTRATION: Current Controlled Trials ISRCTN22060616 (Date assigned: 12 September 2008). BioMed Central 2014-08-18 /pmc/articles/PMC4148532/ /pubmed/25134530 http://dx.doi.org/10.1186/1756-0500-7-541 Text en © Genz et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Short Report
Genz, Jutta
Haastert, Burkhard
Müller, Hardy
Verheyen, Frank
Cole, Dennis
Rathmann, Wolfgang
Nowotny, Bettina
Roden, Michael
Giani, Guido
Ohmann, Christian
Icks, Andrea
Socioeconomic factors and effect of evidence-based patient information about primary prevention of type 2 diabetes mellitus - are there interactions?
title Socioeconomic factors and effect of evidence-based patient information about primary prevention of type 2 diabetes mellitus - are there interactions?
title_full Socioeconomic factors and effect of evidence-based patient information about primary prevention of type 2 diabetes mellitus - are there interactions?
title_fullStr Socioeconomic factors and effect of evidence-based patient information about primary prevention of type 2 diabetes mellitus - are there interactions?
title_full_unstemmed Socioeconomic factors and effect of evidence-based patient information about primary prevention of type 2 diabetes mellitus - are there interactions?
title_short Socioeconomic factors and effect of evidence-based patient information about primary prevention of type 2 diabetes mellitus - are there interactions?
title_sort socioeconomic factors and effect of evidence-based patient information about primary prevention of type 2 diabetes mellitus - are there interactions?
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4148532/
https://www.ncbi.nlm.nih.gov/pubmed/25134530
http://dx.doi.org/10.1186/1756-0500-7-541
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